Provider Demographics
NPI:1215154356
Name:OSTEOPATHIC HEALTHCARE OF MAINE, P.A.
Entity type:Organization
Organization Name:OSTEOPATHIC HEALTHCARE OF MAINE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:V
Authorized Official - Last Name:HANKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:207-781-7900
Mailing Address - Street 1:98 CLEARWATER DR
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04105-1398
Mailing Address - Country:US
Mailing Address - Phone:207-781-7900
Mailing Address - Fax:207-781-2900
Practice Address - Street 1:98 CLEARWATER DR
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04105
Practice Address - Country:US
Practice Address - Phone:207-781-7900
Practice Address - Fax:207-781-2900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2018-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEMM7302Medicare UPIN