EDWARD ALEXANDER MCGILLICUDDY (NPI# 1548593270) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548593270 |
| Entity Type | Individual |
| Full Name | EDWARD ALEXANDER MCGILLICUDDY |
| Credential | M.D. |
| Practice Address |
60 High St Lewiston ME 04240-7616 |
| Practice Telephone | 2077533910 |
| Mailing Telephone | 2077533910 |
| Enumeration Date | 2009-09-14 |
| Last Update Date | 2015-07-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
MD20615 | ME | Allopathic & Osteopathic Physicians |
| Street Address |
60 HIGH ST |
| City | LEWISTON |
| State | ME |
| Zip Code | 04240-7616 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578558532 | Richard S Shulman | Internal Medicine | 60 High St, Lewiston, ME 04240-7616 | 2005-09-15 |
| 1316590946 | Jonathan Mcdonough | Physician Assistant | 60 High St, Cmhvi Y1, Lewiston, ME 04240-7616 | 2019-07-23 |
| 1740841311 | Jade Elaine Bowden Stuart | Speech-Language Pathologist | 60 High St, Lewiston, ME 04240-7616 | 2019-06-25 |
| 1093299463 | Lindsay Rose Houlihan | Physician Assistant | 60 High St, Lewiston, ME 04240-7616 | 2018-09-20 |
| 1508346768 | Kirsten Haas | Physician Assistant | 60 High St, Lewiston, ME 04240-7616 | 2018-08-17 |
| 1043671506 | Karen Shepard | Nurse Practitioner | 60 High St, Lewiston, ME 04240-7616 | 2016-03-11 |
| 1699136135 | Kari Price-cain | Nurse Practitioner | 60 High St, Lewiston, ME 04240-7616 | 2016-03-11 |
| 1881091387 | Tiffany Eisenhauer | Physician Assistant | 60 High St, Lewiston, ME 04240-7616 | 2014-11-26 |
| 1740541317 | Susan R Horton | Nurse Practitioner | 60 High St, Lewiston, ME 04240-7616 | 2012-05-31 |
| 1245516723 | Kevin Taylor Quigley | Physician Assistant | 60 High St, Lewiston, ME 04240-7616 | 2011-10-27 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538773882 | Hannah Page Guerrette | Speech-Language Pathologist | 2 Strawberry Ave, Lewiston, ME 04240 | 2020-09-03 |
| 1497392500 | Samuel C Larouche | Social Worker | 100 Campus Ave Stes A&b, Lewiston, ME 04240 | 2019-12-09 |
| 1972145019 | Pomarand Behavioral Services | Nurse Practitioner | 217 Main St., Suite 201, Lewiston, ME 04240 | 2019-10-10 |
| 1396248258 | William Bucklin | Counselor | 17 Main St Fl 2, Lewiston, ME 04240 | 2018-03-16 |
| 1548769524 | Kevin Ryan | Physician Assistant | 12 High Street Suite 102, Lewiston, ME 04240 | 2018-02-06 |
| 1033637673 | Wellness Center | Clinic/Center | 37 Park Street, Suite 305, Lewiston, ME 04240 | 2017-09-04 |
| 1710404561 | Colasante Chiropractic, LLC | Clinic/Center | 184 Webster Street, #100, Lewiston, ME 04240 | 2017-08-23 |
| 1609398544 | Lindsey Laforge | Occupational Therapist | 984 1/2 Sabattus Street, Lewiston, ME 04240 | 2017-07-12 |
| 1861922478 | Seth Toothaker | Counselor | 1190 Lisbon Street, Lewiston, ME 04240 | 2017-06-15 |
| 1861850828 | Black Bear Support Services, LLC | Community/Behavioral Health | 571 Sabattus Street, Suite 15, Lewiston, ME 04240 | 2016-02-05 |
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| 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 |
|---|---|---|---|---|
| 1124007810 | Pamela R Rietschel | Surgery | 60 High St, Lewiston, ME 04240-7616 | 2006-01-11 |
| 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 |
| 1649430315 | Christopher Hilles Byrne | Surgery | 489 State St, Vascular Care of Maine, Bangor, ME 04401-6616 | 2008-06-16 |
| 1023281078 | Webber Hospital Association | Surgery | 3 Medical Center Dr, Biddeford, ME 04005-9422 | 2008-04-10 |
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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.