Provider Demographics
NPI:1124437942
Name:RODNEY J. VOISINE, MD, PA
Entity type:Organization
Organization Name:RODNEY J. VOISINE, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:J
Authorized Official - Last Name:VOISINE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:207-774-7700
Mailing Address - Street 1:75 JOHN ROBERTS RD
Mailing Address - Street 2:B10
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-6961
Mailing Address - Country:US
Mailing Address - Phone:207-774-7700
Mailing Address - Fax:207-774-7701
Practice Address - Street 1:75 JOHN ROBERTS RD
Practice Address - Street 2:B10
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-6961
Practice Address - Country:US
Practice Address - Phone:207-774-7700
Practice Address - Fax:207-774-7701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-06
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME016302207L00000X, 207RB0002X
MER028856363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RB0002XAllopathic & Osteopathic PhysiciansInternal MedicineObesity MedicineGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty