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Contact Information

JONATHAN T FANBURG, MD
5 BUCKNAM ROAD
SUITE 1D
FALMOUTH, ME04105-1208
 Phone: 207-781-1775
 Fax: 207-781-1780
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Adolescent Medicine

2080A0000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for JONATHAN T FANBURG · (Male)

NPI Number 1275574311
Status Active
Credentials MD
Entity Individual
Enumeration date 06/09/2006
Last updated 06/26/2012 - About 14 years ago
Sole proprietor 1 No
Identifiers
  • ME License # MD14878
  • ME Medicaid 282610099
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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