Provider Demographics
NPI:1063625283
Name:SAVIDGE, GEORGE P (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:P
Last Name:SAVIDGE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:G. PAUL
Other - Middle Name:
Other - Last Name:SAVIDGE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 2617
Mailing Address - Street 2:
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04116-2617
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:92 DARLING AVE
Practice Address - Street 2:
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-2302
Practice Address - Country:US
Practice Address - Phone:207-773-7247
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME008503207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
B86875Medicare UPIN