Provider Demographics
NPI:1790856490
Name:CALVIN P FUHRMANN MD PA
Entity Type:Organization
Organization Name:CALVIN P FUHRMANN MD PA
Other - Org Name:KENNEBUNK MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER AND PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:CALVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:FUHRMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:207-985-3726
Mailing Address - Street 1:24 PORTLAND RD
Mailing Address - Street 2:
Mailing Address - City:KENNEBUNK
Mailing Address - State:ME
Mailing Address - Zip Code:04043-6630
Mailing Address - Country:US
Mailing Address - Phone:207-985-3726
Mailing Address - Fax:207-985-9293
Practice Address - Street 1:24 PORTLAND RD
Practice Address - Street 2:
Practice Address - City:KENNEBUNK
Practice Address - State:ME
Practice Address - Zip Code:04043-6630
Practice Address - Country:US
Practice Address - Phone:207-985-3726
Practice Address - Fax:207-985-9293
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEM170810OtherCIGNA
ME133330000Medicaid
ME2321871OtherAETNA
MECG4828Medicare PIN
ME2321871OtherAETNA