Provider Demographics
NPI:1124065073
Name:STURMER, PAUL J (PHD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:J
Last Name:STURMER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 COTTAGE ST STE F
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04073-1835
Mailing Address - Country:US
Mailing Address - Phone:207-727-6585
Mailing Address - Fax:833-727-6585
Practice Address - Street 1:312 COTTAGE ST STE F
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:ME
Practice Address - Zip Code:04073-1835
Practice Address - Country:US
Practice Address - Phone:207-727-6585
Practice Address - Fax:833-727-6585
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-01
Last Update Date:2022-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPS1008103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME098303OtherANTHEM LEGACY NUMBER
ME1124065073Medicaid
E300145798Medicare PIN