Provider Demographics
NPI:1679662563
Name:HOWE, ALLYSON S (MD)
Entity Type:Individual
Prefix:
First Name:ALLYSON
Middle Name:S
Last Name:HOWE
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 1:100 GANNETT DRIVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106
Mailing Address - Country:US
Mailing Address - Phone:207-828-0361
Mailing Address - Fax:207-874-1483
Practice Address - Street 1:50 FODEN RD STE 3
Practice Address - Street 2:
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-1718
Practice Address - Country:US
Practice Address - Phone:207-523-8500
Practice Address - Fax:207-523-8591
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD17847207Q00000X, 207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30207881Medicaid
ME432976299Medicaid
ME000820801Medicare PIN
ME432976299Medicaid
MEP00679035Medicare PIN
ME000820802Medicare PIN
ME000820803Medicare PIN