Provider Demographics
NPI:1194805812
Name:MAINE NEUROLOGY, P.A.
Entity type:Organization
Organization Name:MAINE NEUROLOGY, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:RIOUX
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:207-884-4391
Mailing Address - Street 1:49 SPRING ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04074-8926
Mailing Address - Country:US
Mailing Address - Phone:207-883-1414
Mailing Address - Fax:207-883-1010
Practice Address - Street 1:49 SPRING ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:SCARBOROUGH
Practice Address - State:ME
Practice Address - Zip Code:04074-8926
Practice Address - Country:US
Practice Address - Phone:207-883-1414
Practice Address - Fax:207-883-1010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty