Provider Demographics
NPI:1194794859
Name:ZEITLIN, JAMES H (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:H
Last Name:ZEITLIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:100 FODEN ROAD WEST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-2327
Mailing Address - Country:US
Mailing Address - Phone:207-828-0361
Mailing Address - Fax:207-874-1483
Practice Address - Street 1:84 MARGINAL WAY
Practice Address - Street 2:SUITE 700
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101-2443
Practice Address - Country:US
Practice Address - Phone:207-774-5816
Practice Address - Fax:207-523-8597
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2010-11-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ME014314207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
018228OtherANTHEM
1041941OtherAETNA
ME303660099Medicaid
ME303660099Medicaid
1041941OtherAETNA
MM6524Medicare ID - Type Unspecified