Jaime L Petrus in So Portland - Pediatrics

Jaime L Petrus - NPI 1891881447

Jaime L Petrus is a Pediatrics in So Portland, Maine. Jaime L Petrus practices all healthcare services and medical treatments related to Pediatrics. The NPI Number for Jaime L Petrus is 1891881447. The last update date is 2009-02-23.

Jaime L Petrus's current location address is 39 Wallace Ave, So Portland, Maine. You can contact this provider via phone number 2077610650 and fax number 2077618198. The mailing address for Jaime L Petrus is 39 Wallace Ave, So Portland, Maine. To know further, please read the information below!

Provider Profile Detail

Provider Name Jaime L Petrus
Address 39 Wallace Ave, So Portland, Maine
Phone Number 2077610650
Fax Number 2077618198
Sole Proprietor N
Credentials MD

NPI Number Detail

NPI Number 1891881447
Provider Enumeration Date 2006-10-04
Last Updated Date 2009-02-23

Provider Mailing Address Detail

Address 39 Wallace Ave
City So Portland
State Maine (ME)
Post Code 4106
Phone Number 2077610650
Fax Number 2077618198

Provider's Primary Taxonomy Detail

Speciality Pediatrics
Taxonomy 208000000X
Licence No 17196
Definition:
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and

Provider's Other Legacy Identifiers

Identifier Identifier Type Identifier State Identifier Issuer
30206869 NH --
432616699 ME --

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FAQs about Jaime L Petrus

What is the Jaime L Petrus's unique identification number?

The Jaime L Petrus has been assigned the NPI (National Provider Identifier) Number 1891881447 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.

Could you provide the complete address where Jaime L Petrus is physically located?

The Jaime L Petrus is situated at the following address: 39 Wallace Ave, So Portland, ME 4106.

What is the Jaime L Petrus's area of specialization and corresponding taxonomy classification?

The Jaime L Petrus's specialty field is Pediatrics, and it falls under the taxonomy code 208000000X, which categorizes healthcare providers based on their specialties.

On what date did the Centers for Medicare & Medicaid Services assign the 1891881447 to Jaime L Petrus?

The Centers for Medicare & Medicaid Services assigned the 1891881447 to Jaime L Petrus on 2006-10-04.

As of what date was the information pertaining to Jaime L Petrus, such as address, specialty, and other details, last reviewed and confirmed to be accurate?

The information related to Jaime L Petrus, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2009-02-23.

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