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Contact Information

SOUTHERN MAINE GERIATRICS ASSOCIATES LLC
50 MARQUIS RD
FREEPORT, ME04032-6477
 Phone: 207-865-6131
 Fax: 207-865-9399
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatric Medicine

207RG0300X 11 Physician/Internal Medicine
 

Acute Care

363LA2100X 50 Nurse Practitioner
 

Adult Health

363LA2200X 50 Nurse Practitioner
 

Family

363LF0000X 50 Nurse Practitioner
 

Geriatric Medicine

207QG0300X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for SOUTHERN MAINE GERIATRICS ASSOCIATES LLC · (Female)

NPI # 1366553091
Status Active
Credentials
Entity Individual
Enumeration date 08/31/2006
Last updated 09/12/2013 - About 13 years ago
Sole proprietor 1 Not specified
Identifiers
  • ME Medicaid 134840000
  • NH Medicaid 30214096
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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