KENNETH MAISAK, DPM, Surgery, Foot & Ankle PORTLAND, ME

Contact Information

KENNETH MAISAK, DPM

68 MARGINAL WAY
PORTLAND, ME 04101-2444

Phone: 207-879-1339
Fax: 207-879-1092
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Surgery, Foot & Ankle	213ES0103X	48	Podiatry

Indicates primary specialty

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NPI Profile & details for KENNETH MAISAK · (Male)

NPI Number	`1710125596`
Status	Active
Credentials	DPM (Doctor of Podiatric Medicine)
Entity	Individual
Enumeration date	02/02/2009
Last updated	09/05/2012 - About 14 years ago
Sole proprietor ¹	No
Identifiers	ME License # POD1077
Hospital affiliation(s)	MAINE MEDICAL CENTER - (Acute Care) 22 BRAMHALL ST PORTLAND, ME 04102

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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