Provider Demographics
NPI:1861456188
Name:MEADOWS, PAUL (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:MEADOWS
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 1:9 HEALTHCARE DRIVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005-3747
Mailing Address - Country:US
Mailing Address - Phone:207-282-9080
Mailing Address - Fax:207-282-9180
Practice Address - Street 1:9 HEALTHCARE DRIVE
Practice Address - Street 2:SUITE 105
Practice Address - City:BIDDEFORD
Practice Address - State:ME
Practice Address - Zip Code:04005-9404
Practice Address - Country:US
Practice Address - Phone:207-282-3666
Practice Address - Fax:207-282-4281
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME010631207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEB86509OtherHARVARD PILGRIM
MEM20001401OtherCIGNA
ME017214OtherANTHEM
ME1040898OtherAETNA
ME257910099Medicaid
B86509Medicare UPIN
MEB86509OtherHARVARD PILGRIM
ME01503801Medicare PIN