Provider Demographics
NPI:1588756738
Name:ANDERSON, JOSEPH H (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:H
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:16 FAHEY ST
Mailing Address - Street 2:SUITE 107
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-6029
Mailing Address - Country:US
Mailing Address - Phone:207-338-4257
Mailing Address - Fax:207-338-4258
Practice Address - Street 1:16 FAHEY ST
Practice Address - Street 2:SUITE 107
Practice Address - City:BELFAST
Practice Address - State:ME
Practice Address - Zip Code:04915-6029
Practice Address - Country:US
Practice Address - Phone:207-338-4257
Practice Address - Fax:207-338-4258
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2011-12-21
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Provider Licenses
StateLicense IDTaxonomies
ME016413208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME432095800Medicaid
ME432095800Medicaid
MEI45139Medicare UPIN