Provider Demographics
NPI:1962423194
Name:FILE, PETER MICHAEL (DO)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:MICHAEL
Last Name:FILE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:491 US ROUTE 1
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04032-7021
Mailing Address - Country:US
Mailing Address - Phone:207-865-6655
Mailing Address - Fax:207-865-6653
Practice Address - Street 1:491 US ROUTE 1
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:ME
Practice Address - Zip Code:04032-7021
Practice Address - Country:US
Practice Address - Phone:207-865-6655
Practice Address - Fax:207-865-6653
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-22
Last Update Date:2007-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME1256204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
Provider Identifiers
StateIdentifier IDID TypeIssuer
MED93068Medicare UPIN
MEMM2040Medicare PIN