Provider Demographics
NPI:1609813443
Name:PAULDING, STEPHEN B (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:B
Last Name:PAULDING
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 1:21 QUIET LN
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04103-2269
Mailing Address - Country:US
Mailing Address - Phone:207-878-3288
Mailing Address - Fax:
Practice Address - Street 1:409 ROOSEVELT TRL
Practice Address - Street 2:
Practice Address - City:WINDHAM
Practice Address - State:ME
Practice Address - Zip Code:04062-4821
Practice Address - Country:US
Practice Address - Phone:207-893-0290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2013-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME006371207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME5940002OtherAETNA
ME1609813443OtherTRICARE
ME610016401OtherCIGNA
MEB86925OtherHARVARD PILGRIM HEALTHCAR
ME010453642OtherMEDNET
ME027361OtherANTHEM
ME010453642OtherONE HEALTH PLAN
ME272330099Medicaid
ME080131508OtherRR MEDICARE
MEB86925OtherHARVARD PILGRIM HEALTHCAR
ME610016401OtherCIGNA