Provider Demographics
NPI:1629208095
Name:DIGBY, CHARLES E (DO)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:E
Last Name:DIGBY
Suffix:
Gender:M
Credentials:DO
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 DR
Mailing Address - Street 2:
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005-9422
Mailing Address - Country:US
Mailing Address - Phone:207-282-3349
Mailing Address - Fax:
Practice Address - Street 1:46 BARRA ROAD
Practice Address - Street 2:SUITES 201/202
Practice Address - City:BIDDEFORD
Practice Address - State:ME
Practice Address - Zip Code:04005
Practice Address - Country:US
Practice Address - Phone:207-282-3349
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-20
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS12299207R00000X
MEDO2558207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL009631800Medicaid
FLP01278403OtherMEDICARE RAILROAD PROVIDER NUMBER
FLP01278403OtherMEDICARE RAILROAD PROVIDER NUMBER