- Practice location
- 11 Madison Avenue, Lamoine, ME 04605
- Phone
- 207-200-1464
- Fax
- 207-805-8421
- Last updated
- April 1, 2016
Black Dog Medical PA is a healthcare organization based in Lamoine, ME. Black Dog Medical PA practices in Lamoine, ME. The NPI Number for Black Dog Medical PA is 1154784668 and holds a License No. MD14569 (ME). The current practice location address for Black Dog Medical PA is 11 Madison Avenue, Lamoine, ME 04605 and can be reached out via phone at 207-200-1464 and via fax at 207-805-8421.
Provider Profile Details
- NPI Number
- 1154784668
- Provider Name
- Black Dog Medical PA
- Provider Entity Type
- Organization
- Address
- 11 Madison Avenue, Lamoine, ME 04605
- Phone Number
- 207-200-1464
- Fax Number
- 207-805-8421
- Primary Taxonomy
- Internal Medicine · 207R00000X
- Organization Subpart
- No
- Authorized Official
- Patricia Wyshak, MD · Owner · 207-200-1464
- Provider Enumeration Date
- April 1, 2016
- Last Update Date
- April 1, 2016
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 11 Madison Avenue
Lamoine, ME 04605 - City
- Lamoine
- State
- Maine
- Zip
- 04605
- Phone Number
- 207-200-1464
- Fax Number
- 207-805-8421
Provider Business Mailing Address Details
- Address
- 11 Madison Avenue
Lamoine, ME 04605 - City
- Lamoine
- State
- ME
- Zip
- 04605
- Phone Number
- 207-200-1464
- Fax Number
- 207-805-8421
License Information
- License Number
- MD14569
- License State
- ME
- Taxonomy
- Internal Medicine · 207R00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Internal Medicine providers near Lamoine, ME
View all Internal Medicine providers in Lamoine →Frequently Asked Questions
What is the NPI number of Black Dog Medical PA?
The NPI number of Black Dog Medical PA is 1154784668. It was assigned on April 1, 2016 and is currently active in the NPPES registry.
What is the specialty of Black Dog Medical PA?
Black Dog Medical PA is registered under the primary taxonomy Internal Medicine (code 207R00000X), licensed in ME under license number MD14569.
Where does Black Dog Medical PA practice?
The practice location is 11 Madison Avenue, Lamoine, ME 04605. The office can be reached at 207-200-1464 (phone) or 207-805-8421 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1154784668 directly on the NPPES registry website.