Provider Demographics
NPI:1427123306
Name:PATRAITIS, CYNTHIA A (DO)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:A
Last Name:PATRAITIS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1 MEDICAL CENTER DR
Mailing Address - Street 2:PO BOX 626
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005-9422
Mailing Address - Country:US
Mailing Address - Phone:207-282-7531
Mailing Address - Fax:207-286-3787
Practice Address - Street 1:9 HEALTHCARE DR
Practice Address - Street 2:SUITE 208
Practice Address - City:BIDDEFORD
Practice Address - State:ME
Practice Address - Zip Code:04005-9449
Practice Address - Country:US
Practice Address - Phone:207-282-7531
Practice Address - Fax:207-286-3787
Is Sole Proprietor?:No
Enumeration Date:2006-11-23
Last Update Date:2013-11-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ME2059208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME8065346OtherCIGNA
ME1427123306Medicaid
ME9636151OtherAETNA
MEAA120521OtherHARVARD PILGRIM HEALTHCARE
ME1427123306OtherANTHEM
ME1427123306OtherANTHEM