Provider Demographics
NPI:1356349989
Name:SAVAGE, PHILIP M (OD)
Entity type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:M
Last Name:SAVAGE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:824 STILLWATER AVE
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-3614
Mailing Address - Country:US
Mailing Address - Phone:207-947-7554
Mailing Address - Fax:207-945-0085
Practice Address - Street 1:824 STILLWATER AVE
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-3614
Practice Address - Country:US
Practice Address - Phone:207-947-7554
Practice Address - Fax:207-945-0085
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOPT605152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEM23457OtherCIGNA HEALTHCARE
KY039611OtherANTHEM BCBS
MEMNT535OtherHARVARD PILGRIM
KY039611OtherANTHEM BCBS
MEMNT535OtherHARVARD PILGRIM