Provider Demographics
NPI:1205941952
Name:CHAMBERLIN, HAROLD E (DPM)
Entity type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:E
Last Name:CHAMBERLIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 OLD NECK RD
Mailing Address - Street 2:
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04074
Mailing Address - Country:US
Mailing Address - Phone:207-883-1938
Mailing Address - Fax:
Practice Address - Street 1:333 LINCOLN STREET
Practice Address - Street 2:KIMBALL HEALTH CTR
Practice Address - City:SACO
Practice Address - State:ME
Practice Address - Zip Code:04072
Practice Address - Country:US
Practice Address - Phone:207-282-6330
Practice Address - Fax:207-283-3338
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPOD172213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
T31452Medicare UPIN
ME015398Medicare ID - Type Unspecified