DR. DOUGLAS L JICHA (NPI# 1306879325) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1306879325 |
Entity Type | Individual |
Full Name | DR. DOUGLAS L JICHA |
Credential | MD |
Practice Address |
306 Us Route 1 Bldg C Scarborough ME 04074 |
Practice Telephone | 2078855742 |
Practice Fax Number | 2078851494 |
Mailing Telephone | 2078855742 |
Mailing Fax Number | 2078851494 |
Enumeration Date | 2006-07-10 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
006810 | ME | Allopathic & Osteopathic Physicians |
Street Address |
306 US ROUTE 1 BLDG C |
City | SCARBOROUGH |
State | ME |
Zip Code | 04074 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1740283746 | Lisa Peter Howard | Dentist | 306 Us Route 1, Ste D1, Scarborough, ME 04074-7640 | 2005-05-23 |
1285703025 | Maine Rehabilitative Healthcare, LLC | Physical Medicine & Rehabilitation | 306 Us Route 1, Building B South, Scarborough, ME 04074-7640 | 2006-11-07 |
1245231976 | Vincent Paul Herzog | Physical Medicine & Rehabilitation | 306 Us Route 1, Scarborough, ME 04074-7640 | 2005-08-03 |
1740281666 | Robert James Mitchell | Dentist | 306 Us Route 1, Bldg. C-1, Scarborough, ME 04074-7640 | 2005-08-02 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407462443 | Jennifer Marlowe | Counselor | Crossroads Maine 71-us-1, Scarborough, ME 04074 | 2020-09-16 |
1508475724 | Whole Medicine LLC | Family Medicine | 2o Mussey Road, Suite 2, Scarborough, ME 04074 | 2020-07-23 |
1154957793 | Maria Robin Libby | Occupational Therapist | 144 Us-1 #4, Scarborough, ME 04074 | 2020-03-16 |
1558902932 | Daphne Berta Counseling P.C. | Counselor | 636 Route 1, Scarborough, ME 04074 | 2019-10-07 |
1619450574 | Louise Valati | Physical Therapist | Piper Shores, 15 Piper Road, Scarborough, ME 04074 | 2018-09-07 |
1770001315 | Emily Dunuwila | Massage Therapist | 51 Us Route One Suite R2, Scarborough, ME 04074 | 2017-09-04 |
1750808788 | Jill Daicey Hutchison | Physical Therapy Assistant | 67 Pine Point Road, Scarborough, ME 04074 | 2017-08-30 |
1457887580 | Rebecca Shaw | Social Worker | 119 Ash Swamp Road, Scarborough, ME 04074 | 2017-05-10 |
1184168767 | Jessica Ann Kaake | Occupational Therapist | 308 Us Route 1 Ste E1, Scarborough, ME 04074 | 2016-12-15 |
1356895056 | Nancy Gaudet | Counselor | 6 Catherine Drive, Scarborough, ME 04074 | 2016-08-10 |
Find all providers in zip 04074 |
Taxonomy Code | 2086S0129X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Surgery |
Specialization | Vascular Surgery |
A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1346618741 | Carl E Bredenberg Jr. | Surgery | 8 Fox Hill Rd, Cape Elizabeth, ME 04107-2007 | 2015-09-02 |
1477830198 | Maine Vein Center Associates, LLC | Surgery | 21 Northbrook Dr # B, Falmouth, ME 04105-1379 | 2011-11-09 |
1205086196 | Edward Michael Friedman | Surgery | 134 Deep Cv, Raymond, ME 04071-6523 | 2008-09-26 |
1811382773 | Vincent Noori | Surgery | 22 Bramhall St, Portland, ME 04102-3134 | 2015-03-30 |
1386056752 | Michael N Neilson | Surgery | 35 Medical Center Pkwy, Augusta, ME 04330-8160 | 2014-05-20 |
1053750349 | Peter Beaulieu | Surgery | 489 State St, Bangor, ME 04401-6616 | 2013-06-19 |
1770921462 | Kimberly Taylor Malka | Surgery | 22 Bramhall St, Portland, ME 04102 | 2013-06-05 |
1134565492 | Anna Marie Boniakowski | Surgery | 887 Congress St Ste 400, Portland, ME 04102-3163 | 2013-05-14 |
1548593270 | Edward Alexander Mcgillicuddy | Surgery | 60 High St, Lewiston, ME 04240-7616 | 2009-09-14 |
1649430315 | Christopher Hilles Byrne | Surgery | 489 State St, Vascular Care of Maine, Bangor, ME 04401-6616 | 2008-06-16 |
Find all providers with the same taxonomy |
City | SCARBOROUGH |
Zip Code | 04074 |
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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.