MR. DUSTIN R SULAK (NPI# 1427212059) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427212059 |
| Entity Type | Individual |
| Full Name | MR. DUSTIN R SULAK |
| Credential | D.O. |
| Practice Address |
964 Western Ave. Manchester ME 04351 |
| Mailing Address |
170 U.S. Route 1 Suite 200 Falmouth ME 04105 |
| Practice Telephone | 2075128633 |
| Mailing Telephone | 2074820188 |
| Mailing Fax Number | 8886428601 |
| Enumeration Date | 2008-07-14 |
| Last Update Date | 2019-06-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | DO2142 | ME | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | T0861 | ME | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ME | 433021499 | 05 |
| Street Address |
964 WESTERN AVE. |
| City | MANCHESTER |
| State | ME |
| Zip Code | 04351 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497171318 | Peter J Volk | Family Medicine | 23 Bowdoin Street, Manchester, ME 04351 | 2014-03-17 |
| 1740563428 | Insight-premier Health LLC | Clinic/Center | 27 Bowdoin Street, Manchester, ME 04351 | 2011-09-20 |
| 1427353069 | Robin Page Dufour | Physical Therapist | 6 Rockwood Dr, Suite 2, Manchester, ME 04351 | 2011-01-12 |
| 1174839708 | Richard Ofoe Kavi | Pharmacist | 943 Western Ave, Manchester, ME 04351 | 2010-08-20 |
| 1700199031 | Neil A Graves | Pharmacist | 943 Western Ave., Manchester, ME 04351 | 2010-07-15 |
| 1437312295 | Crossroads Counseling Center Pllc | Social Worker | 726 Western Ave., Manchester, ME 04351 | 2008-07-02 |
| 1548453616 | Christopher Paul Beaudoin | Social Worker | 15 Range Way Suite 3, Manchester, ME 04351 | 2007-08-22 |
| 1275724288 | Shawn Kenneth Hodgdon | Social Worker | 726 Western Avenue, Manchester, ME 04351 | 2007-08-05 |
| 1790900512 | Scott A Hayward | Social Worker | 15 Range Way, Suite 3, Manchester, ME 04351 | 2007-04-16 |
| 1780747519 | Wendy Brown Jorgensen | Physician Assistant | 1053 Western Avenue, Manchester, ME 04351 | 2006-12-19 |
| Find all providers in zip 04351 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861002701 | Kathleen P Fantozzi | Family Medicine | 1590 Union St, Manchester, NH 03104-1768 | 2020-08-05 |
| 1669098570 | Manchester Family Healthcare | Family Medicine | 804 Keylon St Ste B, Manchester, TN 37355-2414 | 2020-06-17 |
| 1043790413 | Sabrina Bolianites | Family Medicine | 765 S Main St Ste 103, Manchester, NH 03102 | 2018-08-15 |
| 1063912459 | Manchester Alcoholism Rehabilitation Center | Family Medicine | 700 Lake Ave Ste 2, Manchester, NH 03103-2734 | 2018-02-13 |
| 1790204311 | Ballwin Family Medicine LLC | Family Medicine | 653 Big Bend Rd, Manchester, MO 63021-7723 | 2017-09-14 |
| 1659801892 | Pinnacle Health Regional Physicians | Family Medicine | 4314 N George St Ext'd, Manchester, PA 17345-1307 | 2017-06-19 |
| 1083092282 | Alexander Michael Jones | Family Medicine | 4 Elliot Way Ste 105, Manchester, NH 03103 | 2015-05-08 |
| 1164835138 | Amanda Sue Olberding | Family Medicine | 709 West Main St, Manchester, IA 52057 | 2014-06-08 |
| 1497171318 | Peter J Volk | Family Medicine | 23 Bowdoin Street, Manchester, ME 04351 | 2014-03-17 |
| 1689019242 | R. L. Williams Family Medicine, Pllc | Family Medicine | 1000 Mcarthur St, Manchester, TN 37355-2420 | 2013-05-08 |
| Find all providers in MANCHESTER | ||||
| City | MANCHESTER |
| Zip Code | 04351 |
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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.