Provider Demographics
NPI:1487771283
Name:ACADIA OB-GYN ASSOCIATES, P.A.
Entity type:Organization
Organization Name:ACADIA OB-GYN ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:L
Authorized Official - Last Name:FOURNIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-947-6501
Mailing Address - Street 1:68 MOUNT HOPE AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-4096
Mailing Address - Country:US
Mailing Address - Phone:207-947-6501
Mailing Address - Fax:207-941-0146
Practice Address - Street 1:68 MOUNT HOPE AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-4096
Practice Address - Country:US
Practice Address - Phone:207-947-6501
Practice Address - Fax:207-941-0146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1041295OtherAETNA
MES0174OtherANTHEM OF MAINE
MES0174OtherANTHEM OF MAINE