Provider Demographics
NPI:1730110586
Name:PALUSO, EUGENE P (MD)
Entity Type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:P
Last Name:PALUSO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301C US ROUTE 1
Mailing Address - Street 2:
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04074-9701
Mailing Address - Country:US
Mailing Address - Phone:207-396-8600
Mailing Address - Fax:207-396-8632
Practice Address - Street 1:584 ROOSEVELT TRL
Practice Address - Street 2:
Practice Address - City:WINDHAM
Practice Address - State:ME
Practice Address - Zip Code:04062-7302
Practice Address - Country:US
Practice Address - Phone:207-892-3233
Practice Address - Fax:207-893-0752
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME013569207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30207093Medicaid
ME30207093Medicaid
ME311360099Medicaid
NH30207093Medicaid
MEMM495802Medicare PIN
MECX7755Medicare PIN
ME311360099Medicaid
MEMM495801Medicare PIN