Provider Demographics
NPI:1790752632
Name:ARMATIS, CAROL M (MD)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:M
Last Name:ARMATIS
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:PO BOX J
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04953
Mailing Address - Country:US
Mailing Address - Phone:207-368-5747
Mailing Address - Fax:207-368-5483
Practice Address - Street 1:26 MAIN ST
Practice Address - Street 2:SUITE 2
Practice Address - City:NEWPORT
Practice Address - State:ME
Practice Address - Zip Code:04953-4162
Practice Address - Country:US
Practice Address - Phone:207-368-5747
Practice Address - Fax:207-368-5483
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2013-12-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ME013234207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME328080099Medicaid
ME328080099Medicaid
E41924Medicare UPIN