Provider Demographics
NPI:1619916368
Name:DONAHUE, JAMES B (DO)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:B
Last Name:DONAHUE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:491 US ROUTE 1
Mailing Address - Street 2:SUITE 20
Mailing Address - City:FREEPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04032-7022
Mailing Address - Country:US
Mailing Address - Phone:207-865-2225
Mailing Address - Fax:207-865-9990
Practice Address - Street 1:491 US ROUTE 1
Practice Address - Street 2:SUITE 20
Practice Address - City:FREEPORT
Practice Address - State:ME
Practice Address - Zip Code:04032-7022
Practice Address - Country:US
Practice Address - Phone:207-865-2225
Practice Address - Fax:207-865-9990
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2017-04-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MEDO884207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME106640000Medicaid
ME7947889-001OtherCIGNA PROVIDER NUMBER
ME003982OtherANTHEM BLUE CROSS NUMBER
ME4581698OtherAETNA HMO PROVIDER NUMBER
ME98160OtherAETNA PROVIDER NUMBER
MED93096Medicare UPIN
ME7947889-001OtherCIGNA PROVIDER NUMBER