Provider Demographics
NPI:1295786937
Name:SILVERMOUNT WOMENS HEALTHCARE
Entity type:Organization
Organization Name:SILVERMOUNT WOMENS HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:GERIA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:207-872-5529
Mailing Address - Street 1:180 KENNEDY MEMORIAL DR
Mailing Address - Street 2:SUITE 304
Mailing Address - City:WATERVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04901-4540
Mailing Address - Country:US
Mailing Address - Phone:207-872-5529
Mailing Address - Fax:207-872-9219
Practice Address - Street 1:180 KENNEDY MEMORIAL DR
Practice Address - Street 2:SUITE 304
Practice Address - City:WATERVILLE
Practice Address - State:ME
Practice Address - Zip Code:04901-4540
Practice Address - Country:US
Practice Address - Phone:207-872-5529
Practice Address - Fax:207-872-9219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEMM7383Medicare ID - Type Unspecified