Provider Demographics
NPI:1639183718
Name:CVITKOVICH, DONALD G (MD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:G
Last Name:CVITKOVICH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:12 HOSPITAL DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:YORK
Mailing Address - State:ME
Mailing Address - Zip Code:03909-1030
Mailing Address - Country:US
Mailing Address - Phone:207-351-3715
Mailing Address - Fax:207-351-3716
Practice Address - Street 1:12 HOSPITAL DR
Practice Address - Street 2:SUITE C
Practice Address - City:YORK
Practice Address - State:ME
Practice Address - Zip Code:03909-1030
Practice Address - Country:US
Practice Address - Phone:207-351-3715
Practice Address - Fax:207-351-3716
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ME015930207RP1001X
WI51173-20207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME041670OtherBC/BS
ME01Y004052ME01OtherNH BC/BS
753075422OtherMILITARY HEALTH
2885154OtherAETNA
M21490OtherCIGNA HEATHSOURCE
ME189500000Medicaid
2233094OtherCIGNA
D95576OtherHARVARD PILGRIM
D95576Medicare UPIN
753075422OtherMILITARY HEALTH