Basic Information
| Provider Information | |||||||||
| NPI: | 1891707261 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ST. PIERRE-ENGELS | ||||||||
| FirstName: | CAROLE | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 59 LONGVIEW DR | ||||||||
| Address2: | |||||||||
| City: | PRESQUE ISLE | ||||||||
| State: | ME | ||||||||
| PostalCode: | 047692470 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2075401135 | ||||||||
| FaxNumber: | 2077646504 | ||||||||
| Practice Location | |||||||||
| Address1: | 181 ACADEMY ST | ||||||||
| Address2: | SUITE 4 | ||||||||
| City: | PRESQUE ISLE | ||||||||
| State: | ME | ||||||||
| PostalCode: | 047693178 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2077647200 | ||||||||
| FaxNumber: | 2077647201 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/13/2006 | ||||||||
| LastUpdateDate: | 07/09/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 008998 | ME | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 432072899 | 05 | ME | MEDICAID |