Dedekian, Michael A

Dedekian, Michael A is an individual health care provider with primary practice located at 887 Congress St Suite 320, Portland ME 04102. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Endocrinology. Allopathic & Osteopathic Physicians / Pediatric Endocrinology is his primary health care specialty. Dedekian, Michael A can be contacted via phone (207) 662-5522.

Contact Information

Primary practice address
887 Congress St Suite 320 Portland ME 04102
Phone: (207) 662-5522
Fax: (207) 662-5527
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 224852 Massachusetts
Allopathic & Osteopathic Physicians / Pediatric Endocrinology 2080P0205X 017981 Maine

Profile Details

NPI number 1093781254
LBN Legal business name Dedekian, Michael A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 27th, 2006
Last updated Jan 4th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093781254 NPPES
New Hampshire MEDICAID 30208479
New Hampshire MEDICAID 433775099
New Hampshire MEDICAID 2110318

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