1205881042 NPI number — CHRISTOPHER B MAIONA M.D.

Table of content: CHRISTOPHER B MAIONA M.D. (NPI 1205881042)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205881042 NPI number — CHRISTOPHER B MAIONA M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MAIONA
Provider First Name:
CHRISTOPHER
Provider Middle Name:
B
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1205881042
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/05/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 247
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTH VASSALBORO
Provider Business Mailing Address State Name:
ME
Provider Business Mailing Address Postal Code:
04962-0247
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
207-626-1000
Provider Business Mailing Address Fax Number:
207-621-7277

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6 E CHESTNUT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AUGUSTA
Provider Business Practice Location Address State Name:
ME
Provider Business Practice Location Address Postal Code:
04330-5717
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
207-626-1000
Provider Business Practice Location Address Fax Number:
207-621-7277
Provider Enumeration Date:
05/23/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208M00000X , with the licence number:  015914 , registered in the state of ME ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 110240782 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7105055 . This is a "AETNA NON HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 043888 . This is a "ANTHEM" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: H04731 . This is a "HARVARD PILGRIM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2845586 . This is a "AETNA HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 274930099 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".




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