Mmc Family Practice Residency Program

LBN: Mainehealth
Mmc Family Practice Residency Program is an health care organization with primary practice located at 272 Congress St , Portland ME 04102. The organization recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Allopathic & Osteopathic Physicians / Family Medicine, Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Women's Health. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty. Mainehealth can be contacted via phone (207) 874-2466, or through Inzana, Lugene Anthony via phone (207) 662-3538.

Contact Information

Primary practice address
272 Congress St Portland ME 04102
Phone: (207) 874-2466
Fax: (207) 774-4625
Website:
Map and Directions
Authorized official contact:
Name: Inzana, Lugene Anthony
Phone: (207) 662-3538

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X
Physician Assistants & Advanced Practice Nursing Providers / Women's Health 363LW0102X

Profile Details

NPI number 1225232606
LBN Legal business name Mainehealth
DBA Doing business as Mmc Family Practice Residency Program
Authorized official Inzana, Lugene Anthony
Entity Organization
Organization subpart 1 No
Enumeration date Jun 12th, 2007
Last updated Apr 24th, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225232606 NPPES
New Hampshire MEDICAID 30216370

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