Provider Demographics
NPI:1750549044
Name:MANAGES, SAMUELA EUDORA (MD)
Entity type:Individual
Prefix:DR
First Name:SAMUELA
Middle Name:EUDORA
Last Name:MANAGES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 40
Mailing Address - Street 2:
Mailing Address - City:CARIBOU
Mailing Address - State:ME
Mailing Address - Zip Code:04736-0040
Mailing Address - Country:US
Mailing Address - Phone:207-498-2359
Mailing Address - Fax:207-498-3947
Practice Address - Street 1:151 EVERETT AVE
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:MA
Practice Address - Zip Code:02150-1812
Practice Address - Country:US
Practice Address - Phone:617-884-8302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-23
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME017911207Q00000X
MEMD17911207QA0401X
MA291194207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine