DR. WILLIAM DEAN JEANBLANC (NPI# 1083727606) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083727606 |
| Entity Type | Individual |
| Full Name | DR. WILLIAM DEAN JEANBLANC |
| Credential | M.D. |
| Practice Address |
22 Bramhall St Portland ME 04102-3134 |
| Practice Telephone | 2076622816 |
| Practice Fax Number | 2076626783 |
| Mailing Telephone | 2076622816 |
| Mailing Fax Number | 2076626783 |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2008-10-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0805X |
Psychiatry & Neurology Specialization: Geriatric Psychiatry |
016127 | ME | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NH | 3000355 | 05 |
| Street Address |
22 BRAMHALL ST |
| City | PORTLAND |
| State | ME |
| Zip Code | 04102-3134 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386641355 | Suzanne Maynard | Specialist | 22 Bramhall St, Dept of Anesthesiology, Portland, ME 04102 | 2005-07-05 |
| 1902406135 | Barbara Lewis-armstrong | Social Worker | 22 Bramhall St, Portland, ME 04102-3175 | 2020-10-27 |
| 1285231217 | Malia Haddock | Nurse Practitioner | 22 Bramhall St, Portland, ME 04102-3134 | 2020-10-02 |
| 1972118222 | Morgan O'brien | Nurse Practitioner | 22 Bramhall St, Portland, ME 04102-3134 | 2020-09-14 |
| 1295349900 | Natalie Margaret Petrone | Occupational Therapist | 22 Bramhall St, Portland, ME 04102-3175 | 2020-09-01 |
| 1467065565 | Mandi Ann Horwath | Nurse Practitioner | 22 Bramhall St, Portland, ME 04102-3134 | 2020-08-28 |
| 1922610492 | Diana Christine Hubbell | Registered Nurse | 22 Bramhall St, Portland, ME 04102-3134 | 2020-08-17 |
| 1790393023 | Rami Waked | Student in an Organized Health Care Education/Training Program | 22 Bramhall St, Portland, ME 04102-3134 | 2020-07-22 |
| 1871117143 | Lesley Raley | Pharmacist | 22 Bramhall St, Portland, ME 04102-3134 | 2020-06-03 |
| 1023638707 | Rebecca Naomi Glass | Physical Therapist | 22 Bramhall St, Portland, ME 04102-3134 | 2020-04-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720602964 | Ci Yen Joanna Man | Student in an Organized Health Care Education/Training Program | 190 Park Ave., Portland, ME 04102 | 2020-06-03 |
| 1841811338 | Abby Zarotny Sahagian | Nurse Anesthetist, Certified Registered | Mmc Anesthesia and Perioperative Medicine, 22 Bramhall St, Portland, ME 04102 | 2020-05-06 |
| 1124656863 | Zachary Bernard Tillett | Student in an Organized Health Care Education/Training Program | Maine Medical Center 22 Bramhall St., Portland, ME 04102 | 2020-03-30 |
| 1215564323 | Joshua Allen Swenson | Student in an Organized Health Care Education/Training Program | 33 Bramhall St, Portland, ME 04102 | 2020-03-26 |
| 1740776434 | Rishi Phakey | Dentist | Community Dental, 190 Park Ave, Portland, ME 04102 | 2018-07-05 |
| 1982192571 | Jessica Thomas | Doula | 619 Brighton Ave #101, Rosemont Wellness Center, Portland, ME 04102 | 2018-04-29 |
| 1699270744 | Shane D Kirkegaard | Student in an Organized Health Care Education/Training Program | Maine Medical Center 22 Bramhall Street, Portland, ME 04102 | 2018-03-29 |
| 1144752494 | Al-shawk Home Healthcare, LLC | Technician | 640 Brighton Ave Ste 8, Portland, ME 04102 | 2017-03-28 |
| 1376074674 | Samuel B Potter | Emergency Medicine | Maine Medical Center, 22 Bramhall Street, Portland, ME 04102 | 2017-03-27 |
| 1043767536 | Kevin De Ruiter | Social Worker | 129 Pine St Apt 6, Portland, ME 04102 | 2016-09-01 |
| Find all providers in zip 04102 | ||||
| Taxonomy Code | 2084P0805X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Geriatric Psychiatry |
| Geriatric Psychiatry is a subspecialty with psychiatric expertise in prevention, evaluation, diagnosis and treatment of mental and emotional disorders in the elderly, and improvement of psychiatric care for healthy and ill elderly patients. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760674071 | Geriatric Psychiatry Associates Northwest, P.C. | Psychiatry & Neurology | 1231 Ne Mlk Jr Blvd, #611, Portland, OR 97232-2073 | 2007-08-10 |
| 1669608402 | Julie Anne Cohn | Psychiatry & Neurology | 2222 Nw Lovejoy St, Portland, OR 97210-3033 | 2009-06-08 |
| 1356459978 | Sahana Misra | Psychiatry & Neurology | 3710 Sw Us Veterans Hospital Rd, Portland, OR 97239-2964 | 2006-08-25 |
| 1023121860 | Linda Ganzini | Psychiatry & Neurology | 3710 Sw Us Veterans Hospital Rd, Mental Health Division, P3mhdc, Portland, OR 97239-2964 | 2006-08-16 |
| 1366450801 | Kevin Ray Smith | Psychiatry & Neurology | 3181 Sw Sam Jackson Park Rd, Up, Portland, OR 97239-3011 | 2006-08-03 |
| 1003842832 | David Morrison Douglas | Psychiatry & Neurology | 3710 Sw Us Veterans Hospital Rd, Portland, OR 97239-2964 | 2006-06-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043467343 | Memcare LLC | Psychiatry & Neurology | 27 June St, Third Floor, Sanford, ME 04073-2621 | 2008-08-19 |
| 1023118361 | Clifford M Singer | Psychiatry & Neurology | 268 Stillwater Ave, Bangor, ME 04401-3945 | 2006-09-25 |
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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.