Provider Demographics
NPI:1245731082
Name:MICHAEL ENG, INTEGRATIVE MEDICINE, PLLC
Entity type:Organization
Organization Name:MICHAEL ENG, INTEGRATIVE MEDICINE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ENG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:207-310-3945
Mailing Address - Street 1:PO BOX 398
Mailing Address - Street 2:
Mailing Address - City:BRIDGTON
Mailing Address - State:ME
Mailing Address - Zip Code:04009-0398
Mailing Address - Country:US
Mailing Address - Phone:207-310-3945
Mailing Address - Fax:207-221-1362
Practice Address - Street 1:82 MAIN ST
Practice Address - Street 2:
Practice Address - City:BRIDGTON
Practice Address - State:ME
Practice Address - Zip Code:04009-1128
Practice Address - Country:US
Practice Address - Phone:207-310-3945
Practice Address - Fax:207-221-1362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-27
Last Update Date:2018-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Single Specialty