Provider Demographics
NPI:1962443713
Name:RAMPE, GLENN STEPHEN (MD)
Entity type:Individual
Prefix:
First Name:GLENN
Middle Name:STEPHEN
Last Name:RAMPE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 WHITING HILL RD
Mailing Address - Street 2:
Mailing Address - City:BREWER
Mailing Address - State:ME
Mailing Address - Zip Code:04412-1005
Mailing Address - Country:US
Mailing Address - Phone:207-866-4399
Mailing Address - Fax:
Practice Address - Street 1:84 KELLEY RD
Practice Address - Street 2:
Practice Address - City:ORONO
Practice Address - State:ME
Practice Address - Zip Code:04473-3416
Practice Address - Country:US
Practice Address - Phone:207-866-4399
Practice Address - Fax:207-866-4538
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2013-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME012091207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEMM2543Medicare ID - Type Unspecified
MEC81609Medicare UPIN