Provider Demographics
NPI:1992723340
Name:MAINE ANESTHESIOLOGY
Entity type:Organization
Organization Name:MAINE ANESTHESIOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRESI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:207-879-3385
Mailing Address - Street 1:PO BOX 676
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04243-0676
Mailing Address - Country:US
Mailing Address - Phone:800-720-1664
Mailing Address - Fax:
Practice Address - Street 1:144 STATE ST
Practice Address - Street 2:ANESTHESIA DEPARTMENT
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101-3776
Practice Address - Country:US
Practice Address - Phone:207-879-3385
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
Not Answered207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEMM2415Medicare ID - Type Unspecified