Provider Demographics
NPI:1891707261
Name:ST. PIERRE-ENGELS, CAROLE (MD)
Entity Type:Individual
Prefix:
First Name:CAROLE
Middle Name:
Last Name:ST. PIERRE-ENGELS
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 1:59 LONGVIEW DR
Mailing Address - Street 2:
Mailing Address - City:PRESQUE ISLE
Mailing Address - State:ME
Mailing Address - Zip Code:04769-2470
Mailing Address - Country:US
Mailing Address - Phone:207-540-1135
Mailing Address - Fax:207-764-6504
Practice Address - Street 1:181 ACADEMY ST
Practice Address - Street 2:SUITE 4
Practice Address - City:PRESQUE ISLE
Practice Address - State:ME
Practice Address - Zip Code:04769-3178
Practice Address - Country:US
Practice Address - Phone:207-764-7200
Practice Address - Fax:207-764-7201
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME008998207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME432072899Medicaid
MEE16221Medicare UPIN
ME432072899Medicaid