Provider Demographics
NPI:1518946185
Name:CAINE, BRIAN J (MD)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:J
Last Name:CAINE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 WAYMAN LN
Mailing Address - Street 2:
Mailing Address - City:BAR HARBOR
Mailing Address - State:ME
Mailing Address - Zip Code:04609-1625
Mailing Address - Country:US
Mailing Address - Phone:207-288-5081
Mailing Address - Fax:207-288-8600
Practice Address - Street 1:17 HANCOCK ST
Practice Address - Street 2:
Practice Address - City:BAR HARBOR
Practice Address - State:ME
Practice Address - Zip Code:04609-1714
Practice Address - Country:US
Practice Address - Phone:207-288-5081
Practice Address - Fax:207-288-8646
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2013-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME010005207Q00000X, 207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME010005OtherME - LICENSE
ME1790764512-010Medicaid
MEMM078801Medicare PIN
MEB86407Medicare UPIN