Provider Demographics
NPI:1205903820
Name:ARNOLD MEMORIAL MEDICAL CENTER, PA
Entity type:Organization
Organization Name:ARNOLD MEMORIAL MEDICAL CENTER, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:I
Authorized Official - Last Name:WEISBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:207-497-5614
Mailing Address - Street 1:70 SNARE CREEK LN
Mailing Address - Street 2:
Mailing Address - City:JONESPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04649-3139
Mailing Address - Country:US
Mailing Address - Phone:207-497-5614
Mailing Address - Fax:207-497-5554
Practice Address - Street 1:70 SNARE CREEK LN
Practice Address - Street 2:
Practice Address - City:JONESPORT
Practice Address - State:ME
Practice Address - Zip Code:04649-3139
Practice Address - Country:US
Practice Address - Phone:207-497-5614
Practice Address - Fax:207-497-5554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME1102207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME203849Medicare Oscar/Certification
MEMM6180Medicare ID - Type Unspecified
ME1088980001Medicare NSC