Provider Demographics
NPI:1740327162
Name:BURNHAM, CYNTHIA M (DO)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:M
Last Name:BURNHAM
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:180 US ROUTE ONE #1
Mailing Address - Street 2:
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04074
Mailing Address - Country:US
Mailing Address - Phone:207-289-3640
Mailing Address - Fax:207-883-1040
Practice Address - Street 1:655 MAIN ST
Practice Address - Street 2:
Practice Address - City:SACO
Practice Address - State:ME
Practice Address - Zip Code:04072-1543
Practice Address - Country:US
Practice Address - Phone:207-602-3571
Practice Address - Fax:207-602-3573
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2015-09-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ME11802084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
F34489Medicare UPIN
MM4462Medicare PIN
MEF34489Medicare UPIN