1669426151 NPI number — ANDREW J DIONNE M.D.

Table of content: ANDREW J DIONNE M.D. (NPI 1669426151)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669426151 NPI number — ANDREW J DIONNE M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DIONNE
Provider First Name:
ANDREW
Provider Middle Name:
J
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:
1669426151
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/25/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6 E CHESTNUT ST
Provider Second Line Business Mailing Address:
MGHA HOSPITALIST PROGRAM
Provider Business Mailing Address City Name:
AUGUSTA
Provider Business Mailing Address State Name:
ME
Provider Business Mailing Address Postal Code:
04330-5717
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:
MGHA HOSPITALIST PROGRAM
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:
05/20/2006

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:  015892 , 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: 0061352 . This is a "ANTHEM" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: 313960099 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7338005 . This is a "AETNA NON HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: P00221475 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3840278 . This is a "AETNA HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: AA35723 . This is a "HARVARD PILGRIM" identifier . This identifiers is of the category "OTHER".




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