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Contact Information

STEPHEN R GOLDBAS, DO
195 FORE RIVER PKWY STE 407
PORTLAND, ME04102-2780
 Phone: 207-749-6612
 Fax: 207-747-4077
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Neuromusculoskeletal Medicine & OMM

204D00000X 12 Physician/Osteopathic Manipulative Medicine
 

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for STEPHEN R GOLDBAS · (Male)

NPI # 1003892605
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 12/16/2005
Last updated 03/14/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • ME License # 1678
  • ME Medicaid 1003892605
Hospital affiliation(s)
  • MERCY HOSPITAL - (Acute Care)
    144 STATE STREET
    PORTLAND, ME 04101
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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