Provider Demographics
NPI:1588695811
Name:OPENSHAW, THOMAS H (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:H
Last Name:OPENSHAW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:43 WHITING HILL RD
Mailing Address - Street 2:STE 300
Mailing Address - City:BREWER
Mailing Address - State:ME
Mailing Address - Zip Code:04412-1005
Mailing Address - Country:US
Mailing Address - Phone:207-973-5035
Mailing Address - Fax:207-973-5042
Practice Address - Street 1:33 WHITING HILL RD
Practice Address - Street 2:SUITE 21
Practice Address - City:BREWER
Practice Address - State:ME
Practice Address - Zip Code:04412-1021
Practice Address - Country:US
Practice Address - Phone:207-973-7000
Practice Address - Fax:207-973-5042
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ME012789207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEMM265601OtherMEDICARE B -BLUE HILL MEMORIAL HOSPITAL
MEMM265601OtherMEDICARE B -BLUE HILL MEMORIAL HOSPITAL
MM2656Medicare ID - Type Unspecified