Provider Demographics
NPI:1588651160
Name:FAY, LINDA A (MD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:A
Last Name:FAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325E KENNEDY MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:WATERVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04901-4531
Mailing Address - Country:US
Mailing Address - Phone:207-873-5665
Mailing Address - Fax:207-873-5545
Practice Address - Street 1:325E KENNEDY MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:WATERVILLE
Practice Address - State:ME
Practice Address - Zip Code:04901-4531
Practice Address - Country:US
Practice Address - Phone:207-873-5665
Practice Address - Fax:207-873-5545
Is Sole Proprietor?:No
Enumeration Date:2005-09-29
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME013667207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME160019684OtherRAILROAD MEDICARE
ME312610099Medicaid
MEME0151OtherHARVARD PILGRIM HEALTHCAR
ME1041037OtherAETNA
ME008638OtherANTHEM
ME8038637OtherCIGNA
ME160019684OtherRAILROAD MEDICARE
ME8038637OtherCIGNA