Provider Demographics
NPI:1336147222
Name:SINTETOS, ANTHONY LEE (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:LEE
Last Name:SINTETOS
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:174 KENNEDY MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:WATERVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04901-5134
Mailing Address - Country:US
Mailing Address - Phone:800-395-0232
Mailing Address - Fax:207-861-3281
Practice Address - Street 1:244 KENNEDY MEMORIAL DR
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:WATERVILLE
Practice Address - State:ME
Practice Address - Zip Code:04901-4538
Practice Address - Country:US
Practice Address - Phone:207-861-8030
Practice Address - Fax:207-861-8317
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2009-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG56989207RI0011X
ME018031207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME434197399Medicaid
ME001074201Medicare PIN