Provider Demographics
NPI:1952371684
Name:PRICE, MAURA BEVERLIN (MD)
Entity Type:Individual
Prefix:
First Name:MAURA
Middle Name:BEVERLIN
Last Name:PRICE
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 1:9 HEALTHCARE DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005-9449
Mailing Address - Country:US
Mailing Address - Phone:207-282-9080
Mailing Address - Fax:207-286-9853
Practice Address - Street 1:13 INDUSTRIAL PARK RD
Practice Address - Street 2:
Practice Address - City:SACO
Practice Address - State:ME
Practice Address - Zip Code:04072-1804
Practice Address - Country:US
Practice Address - Phone:207-294-5959
Practice Address - Fax:207-286-9853
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2011-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME013834208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1952371684OtherANTHEM
ME3179933OtherAETNA
M555815OtherCIGNA NH
ME000216065Medicaid
00558749OtherCHAMPUS
NH30205518Medicaid
ME313890099Medicaid
3179924OtherAETNA
H89221Medicare UPIN
NH30205518Medicaid
MEME003701Medicare PIN