Provider Demographics
NPI:1962522300
Name:ATKINS, MARIA A (DO)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:A
Last Name:ATKINS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1375 CONGRESS ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04102-2118
Mailing Address - Country:US
Mailing Address - Phone:207-761-0177
Mailing Address - Fax:
Practice Address - Street 1:1375 CONGRESS ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04102-2118
Practice Address - Country:US
Practice Address - Phone:207-761-0177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME1464207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEG35951Medicare UPIN
MM6523Medicare ID - Type Unspecified