JEAN M LARSON (NPI# 1033206941) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033206941 |
| Entity Type | Individual |
| Full Name | JEAN M LARSON |
| Credential | MD |
| Practice Address |
417 State St Ste 121 Bangor ME 04401-6630 |
| Mailing Address |
43 Whiting Hill Rd Ste 300 Brewer ME 04412-1006 |
| Practice Telephone | 2079734266 |
| Practice Fax Number | 2079735151 |
| Mailing Telephone | 2079735042 |
| Mailing Fax Number | 2079735042 |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2012-02-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | ME100673 | FL | Allopathic & Osteopathic Physicians |
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
018950 | ME | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ME | 1033206941 | 05 | |
| FL | 280216300 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922536754 | Jean M Larson | Dietitian, Registered | 400 E 3rd St, Duluth, MN 55805-1951 | 2017-05-24 |
| 1801257332 | Jean Teresa Larson | Nurse Practitioner | 3301 7th Ave, Anoka, MN 55303 | 2016-03-10 |
| 1487095410 | Jean A Larson | Social Worker | 2118 Chatalet Ln, Pueblo, CO 81005-4625 | 2013-07-05 |
| 1295836732 | Jean E Larson | Physician Assistant | 2405 Osler Ct, Meredyth Professional Plaza, Albany, GA 31707 | 2006-09-26 |
| Street Address |
417 STATE ST STE 121 |
| City | BANGOR |
| State | ME |
| Zip Code | 04401-6630 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912976911 | Joseph Harkins | Physician Assistant | 417 State St Ste 121, Bangor, ME 04401-6630 | 2006-03-14 |
| 1982243747 | Jesse Galovich | Physician Assistant | 417 State St Ste 121, Bangor, ME 04401-6630 | 2019-12-26 |
| 1679839047 | Janese Shade' Laster | Internal Medicine | 417 State St Ste 121, Bangor, ME 04401-6630 | 2012-04-10 |
| 1124066154 | Angel A Fernandez Segura | Internal Medicine | 417 State St Ste 121, Bangor, ME 04401-6630 | 2006-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184222523 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 110 Longview Dr, Bangor, ME 04401 | 2020-10-16 |
| 1033737937 | Daniel John Phulman | Counselor | 202 Exchange Street, Bangor, ME 04401 | 2020-07-08 |
| 1770104358 | Elizabeth Sarah Caruson | Physician Assistant | 417 State Street Webber Medical Building, East St, Ste. 121, Bangor, ME 04401 | 2020-05-05 |
| 1053961300 | Erika Dean | Occupational Therapist | 84 Sylvan Rd., Bangor, ME 04401 | 2019-09-18 |
| 1942853635 | Wildworks Therapy, Pllc | Occupational Therapist | 123 Mt Hope Ave, Bangor, ME 04401 | 2019-07-22 |
| 1255999173 | Jessica Arbisi | Physician Assistant | 1 Northeast Drive, Bangor, ME 04401 | 2019-06-05 |
| 1699232041 | Ehab Khamis Elhefnawi | Anesthesiology | Emmc Anesthesia Professional Service, 489 State Street, Bangor, ME 04401 | 2019-02-21 |
| 1477028884 | Zvorufura Makura | Otolaryngology | 885 Union Street, Ste 145, Bangor, ME 04401 | 2018-10-11 |
| 1255826541 | Lindsey M Fields | Optometrist | 955 Broadway Eye Center Northeast Dba Northeast Eyecare, Bangor, ME 04401 | 2018-06-28 |
| 1992211338 | Debra J Mcintyre | Counselor | 157 Park Street, #5, Bangor, ME 04401 | 2017-12-21 |
| Find all providers in zip 04401 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053712984 | Philip G. Hunter | Internal Medicine | 34 Pine Ledge Rd, Bangor, ME 04401-2031 | 2014-09-10 |
| 1033314620 | Mira Regina Olson | Internal Medicine | 700 Mount Hope Ave Ste 430, Bangor, ME 04401 | 2007-06-15 |
| 1699983536 | Gastroenterology Associates of Eastern Maine | Internal Medicine | 210 Evergreen Woods, Bangor, ME 04401-5655 | 2007-05-21 |
| 1235222043 | Phillip B Amidon | Internal Medicine | 417 State Street, Suite 121, Gastroenterology Center of Maine, Bangor, ME 04401 | 2006-10-02 |
| 1558365502 | Rajiv Dhingra | Internal Medicine | 360 Broadway Ste 100, Bangor, ME 04401-3985 | 2005-06-08 |
| 1578189494 | Bangor Gastroenterology LLC | Internal Medicine | 700 Mount Hope Ave Ste 430, Bangor, ME 04401-5677 | 2020-06-17 |
| 1992105043 | Angeli Chopra | Internal Medicine | 358 Broadway, Suite 100, Bangor, ME 04401-3929 | 2014-08-26 |
| 1023350360 | Michael Paul Sighinolfi | Internal Medicine | 360 Broadway Ste 100, Bangor, ME 04401-3985 | 2013-03-25 |
| 1679839047 | Janese Shade' Laster | Internal Medicine | 417 State St Ste 121, Bangor, ME 04401-6630 | 2012-04-10 |
| 1780983205 | Anan H Said | Internal Medicine | 360 Broadway, Suite 100, Bangor, ME 04401 | 2011-03-23 |
| Find all providers in BANGOR | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.