Provider Demographics
NPI:1801043716
Name:DOWNEAST OSTEOPATHIC HEALTH CENTER, LLC
Entity Type:Organization
Organization Name:DOWNEAST OSTEOPATHIC HEALTH CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:KARL
Authorized Official - Middle Name:FREDRICK
Authorized Official - Last Name:LIEBERMANN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:207-664-2985
Mailing Address - Street 1:130 OAK ST
Mailing Address - Street 2:SUITE 6
Mailing Address - City:ELLSWORTH
Mailing Address - State:ME
Mailing Address - Zip Code:04605-1623
Mailing Address - Country:US
Mailing Address - Phone:207-664-2985
Mailing Address - Fax:
Practice Address - Street 1:130 OAK ST
Practice Address - Street 2:SUITE 6
Practice Address - City:ELLSWORTH
Practice Address - State:ME
Practice Address - Zip Code:04605-1623
Practice Address - Country:US
Practice Address - Phone:207-664-2985
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-21
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME1858261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center