Basic Information
| Provider Information | |||||||||
| NPI: | 1932165990 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | MAINEGENERAL HEALTH ASSOCIATES DBA ONCOLOGY ASSOCIATES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 150 DRESDEN AVE | ||||||||
| Address2: | |||||||||
| City: | GARDINER | ||||||||
| State: | ME | ||||||||
| PostalCode: | 043452615 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2076219337 | ||||||||
| FaxNumber: | 2076261214 | ||||||||
| Practice Location | |||||||||
| Address1: | ONCOLOGY ASSOCIATES | ||||||||
| Address2: | 149 NORTH ST | ||||||||
| City: | WATERVILLE | ||||||||
| State: | ME | ||||||||
| PostalCode: | 04901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2078721140 | ||||||||
| FaxNumber: | 2078721079 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/26/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | CROWLEY | ||||||||
| AuthorizedOfficialFirstName: | BARBARA | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT, MGHA | ||||||||
| AuthorizedOfficialTelephone: | 2076261063 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0003X | NOT APPLICABLE | ME | X | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | 363A00000X | NOT APPLICABLE | ME | X | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.