Provider Demographics
NPI:1457362741
Name:HARMATZ, ALAN S (MD)
Entity Type:Individual
Prefix:MR
First Name:ALAN
Middle Name:S
Last Name:HARMATZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:287 MAIN ST
Mailing Address - Street 2:STE 302
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-7054
Mailing Address - Country:US
Mailing Address - Phone:207-795-6543
Mailing Address - Fax:207-795-0488
Practice Address - Street 1:287 MAIN ST
Practice Address - Street 2:STE 302
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-7054
Practice Address - Country:US
Practice Address - Phone:207-795-6543
Practice Address - Fax:207-795-0488
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2014-10-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ME013448208200000X, 2082S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the Hand
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME291330099Medicaid
G50193Medicare UPIN
MEMM733201Medicare PIN
MEMM733201Medicare PIN