Provider Demographics
NPI:1851381008
Name:FILLITER, NANCY CANN (MD)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:CANN
Last Name:FILLITER
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 1:9 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04963-5034
Mailing Address - Country:US
Mailing Address - Phone:207-465-2181
Mailing Address - Fax:207-465-4629
Practice Address - Street 1:9 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:ME
Practice Address - Zip Code:04963-5034
Practice Address - Country:US
Practice Address - Phone:207-465-2181
Practice Address - Fax:207-465-4629
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2015-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD13453207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME128580099Medicaid
ME017747OtherANTHEM
ME128580099Medicaid
MM4621Medicare ID - Type Unspecified
F48476Medicare UPIN