Provider Demographics
NPI:1780156117
Name:ROSE M FUCHS
Entity type:Organization
Organization Name:ROSE M FUCHS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:
Authorized Official - Last Name:FUCHS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:207-922-9102
Mailing Address - Street 1:17 FOUNDERS ST
Mailing Address - Street 2:
Mailing Address - City:PATTEN
Mailing Address - State:ME
Mailing Address - Zip Code:04765-3080
Mailing Address - Country:US
Mailing Address - Phone:207-922-9102
Mailing Address - Fax:207-922-9080
Practice Address - Street 1:17 FOUNDERS ST
Practice Address - Street 2:
Practice Address - City:PATTEN
Practice Address - State:ME
Practice Address - Zip Code:04765-3080
Practice Address - Country:US
Practice Address - Phone:207-922-9102
Practice Address - Fax:207-922-9080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-25
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty