Provider Demographics
NPI:1801984471
Name:BADEEN, STEVEN J (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:J
Last Name:BADEEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04953-4157
Mailing Address - Country:US
Mailing Address - Phone:207-368-4292
Mailing Address - Fax:
Practice Address - Street 1:8 MAIN ST
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:ME
Practice Address - Zip Code:04953-4157
Practice Address - Country:US
Practice Address - Phone:207-368-4292
Practice Address - Fax:207-368-4250
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME013328207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEB42311Medicare UPIN
ME200028Medicare Oscar/Certification