Provider Demographics
NPI:1245320464
Name:PAUHANA ORTHOPEDICS P.A.
Entity type:Organization
Organization Name:PAUHANA ORTHOPEDICS P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:S
Authorized Official - Last Name:GOLDEN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:207-873-0200
Mailing Address - Street 1:246 KENNEDY MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:WATERVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04901-4556
Mailing Address - Country:US
Mailing Address - Phone:207-873-0200
Mailing Address - Fax:207-872-8382
Practice Address - Street 1:246 KENNEDY MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:WATERVILLE
Practice Address - State:ME
Practice Address - Zip Code:04901-4556
Practice Address - Country:US
Practice Address - Phone:207-873-0200
Practice Address - Fax:207-872-8382
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0462600001Medicare NSC