Provider Demographics
NPI:1124790282
Name:INTERNAL MEDICINE OF SOUTHERN MAINE, LLC
Entity type:Organization
Organization Name:INTERNAL MEDICINE OF SOUTHERN MAINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CUTONE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:207-671-2143
Mailing Address - Street 1:9 SPRUCE AVE
Mailing Address - Street 2:
Mailing Address - City:KENNEBUNKPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04046-5147
Mailing Address - Country:US
Mailing Address - Phone:207-671-2143
Mailing Address - Fax:
Practice Address - Street 1:2 INDEPENDENCE DR STE B
Practice Address - Street 2:
Practice Address - City:KENNEBUNK
Practice Address - State:ME
Practice Address - Zip Code:04043-6078
Practice Address - Country:US
Practice Address - Phone:207-671-2143
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-28
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty