Provider Demographics
NPI:1366510208
Name:SEDGWICK, AMY C (MD)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:C
Last Name:SEDGWICK
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:100 GANNETT DRIVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-5900
Mailing Address - Country:US
Mailing Address - Phone:207-828-0361
Mailing Address - Fax:207-874-1483
Practice Address - Street 1:50 FODEN RD
Practice Address - Street 2:SUITE 3
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-1718
Practice Address - Country:US
Practice Address - Phone:207-523-8500
Practice Address - Fax:207-523-8591
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2020-09-24
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Provider Licenses
StateLicense IDTaxonomies
MEMD17554207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME000382805Medicare PIN
MEE400264782Medicare PIN
ME000382801Medicare PIN
ME000382804Medicare PIN
ME000382803Medicare PIN