Provider Demographics
NPI:1619088010
Name:MORIN, JESSIKA T (MD)
Entity Type:Individual
Prefix:DR
First Name:JESSIKA
Middle Name:T
Last Name:MORIN
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 1:1 MEDICAL CENTER DRIVE
Mailing Address - Street 2:
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005
Mailing Address - Country:US
Mailing Address - Phone:207-282-9080
Mailing Address - Fax:207-282-9128
Practice Address - Street 1:10 GOODALL DRIVE
Practice Address - Street 2:
Practice Address - City:EAST WATERBORO
Practice Address - State:ME
Practice Address - Zip Code:04030
Practice Address - Country:US
Practice Address - Phone:207-490-7760
Practice Address - Fax:207-247-8460
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2014-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0432385207Q00000X
MEMD19755207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine