Provider Demographics
NPI:1841300837
Name:SACCO, CHRISTOPHER E (DPM)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:E
Last Name:SACCO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:287 MAIN ST
Mailing Address - Street 2:STE. 200
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-7054
Mailing Address - Country:US
Mailing Address - Phone:207-782-2256
Mailing Address - Fax:207-514-7651
Practice Address - Street 1:287 MAIN ST
Practice Address - Street 2:STE. 200
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-7054
Practice Address - Country:US
Practice Address - Phone:207-782-2256
Practice Address - Fax:207-514-7651
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPOD240213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME124970099Medicaid
MEU43087Medicare UPIN
MEMM4940Medicare PIN