Provider Demographics
NPI:1740281625
Name:ENDRIZZI, DONALD P (MD)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:P
Last Name:ENDRIZZI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:301C US ROUTE 1
Mailing Address - Street 2:
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04074-9701
Mailing Address - Country:US
Mailing Address - Phone:207-396-8600
Mailing Address - Fax:207-396-8632
Practice Address - Street 1:5 BUCKNAM RD
Practice Address - Street 2:SUITE 1D
Practice Address - City:FALMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04105-1392
Practice Address - Country:US
Practice Address - Phone:207-781-1551
Practice Address - Fax:207-781-1552
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2012-05-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MEMD12325207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEMM101602Medicare PIN
MEB86434Medicare UPIN
MEP01019571Medicare PIN
MEMM101601Medicare PIN