Provider Demographics
NPI:1811094220
Name:CHASSE, WILLIAM RAYMOND (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:RAYMOND
Last Name:CHASSE
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 1:325 B KENNEDY MEMORIAL DRIVE
Mailing Address - Street 2:
Mailing Address - City:WATERVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04901
Mailing Address - Country:US
Mailing Address - Phone:207-873-0737
Mailing Address - Fax:207-861-5446
Practice Address - Street 1:325 B KENNEDY MEMORIAL DRIVE
Practice Address - Street 2:
Practice Address - City:WATERVILLE
Practice Address - State:ME
Practice Address - Zip Code:04901
Practice Address - Country:US
Practice Address - Phone:207-873-0737
Practice Address - Fax:207-861-5446
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME11743207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
001940OtherANTHEM PIN 001940
M60981OtherPIN M60981 GROUP M60980
ME114590099Medicaid
ME114590000Medicaid
040001080OtherRR MEDICARE
001940OtherANTHEM PIN 001940
ME015618Medicare PIN
ME114590000Medicaid