Provider Demographics
NPI:1427145994
Name:HALLOWELL FAMILY PRACTICE LLC
Entity type:Organization
Organization Name:HALLOWELL FAMILY PRACTICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER MD
Authorized Official - Prefix:MR
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:MURRAY-JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:207-626-0606
Mailing Address - Street 1:9 UNION STREET
Mailing Address - Street 2:
Mailing Address - City:HALLOWELL
Mailing Address - State:ME
Mailing Address - Zip Code:04347
Mailing Address - Country:US
Mailing Address - Phone:207-626-0606
Mailing Address - Fax:207-626-0022
Practice Address - Street 1:9 UNION STREET
Practice Address - Street 2:
Practice Address - City:HALLOWELL
Practice Address - State:ME
Practice Address - Zip Code:04347
Practice Address - Country:US
Practice Address - Phone:207-626-0606
Practice Address - Fax:207-626-0022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME015217207Q00000X
ME013527207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
040818OtherANTHEM
8375252001OtherMED UNITED
ME134130000Medicaid
2358881OtherAETNA
ME281780099Medicaid
F53854OtherHARVARD
80167676OtherTRAVELERS MCARE
5281052002OtherCIGNA
80167676OtherRAILROAD MEDICARE
039192OtherANTHEM
2423708OtherAETNA
837525200OtherCIGNA
MN3975OtherHARVARD
ME299990099Medicaid
039192OtherANTHEM
2423708OtherAETNA
837525200OtherCIGNA
8375252001OtherMED UNITED
MM4835Medicare ID - Type UnspecifiedINDIVIDUAL #
MM8870Medicare ID - Type UnspecifiedGROUP #