Basic Information
| Provider Information | |||||||||
| NPI: | 1861456188 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MEADOWS | ||||||||
| FirstName: | PAUL | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9 HEALTHCARE DRIVE | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | BIDDEFORD | ||||||||
| State: | ME | ||||||||
| PostalCode: | 040053747 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2072829080 | ||||||||
| FaxNumber: | 2072829180 | ||||||||
| Practice Location | |||||||||
| Address1: | 9 HEALTHCARE DRIVE | ||||||||
| Address2: | SUITE 105 | ||||||||
| City: | BIDDEFORD | ||||||||
| State: | ME | ||||||||
| PostalCode: | 040059404 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2072823666 | ||||||||
| FaxNumber: | 2072824281 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/13/2006 | ||||||||
| LastUpdateDate: | 01/20/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | 010631 | ME | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | B86509 | 01 | ME | HARVARD PILGRIM | OTHER | M20001401 | 01 | ME | CIGNA | OTHER | 017214 | 01 | ME | ANTHEM | OTHER | 1040898 | 01 | ME | AETNA | OTHER | 257910099 | 05 | ME | MEDICAID |