NORTHEAST NEUROSURGERY, P.A. (NPI# 1962446724) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962446724 |
| Entity Type | Organization |
| Organization Name | NORTHEAST NEUROSURGERY, P.A. |
| Practice Address |
498 Essex St Suite 104 Bangor ME 04401-3990 |
| Practice Telephone | 2079478282 |
| Practice Fax Number | 2079418074 |
| Mailing Telephone | 2079478282 |
| Mailing Fax Number | 2079418074 |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. DAVID WEITMAN (PRESIDENT) |
| Authorized Official Telephone | 2079478282 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207T00000X | Neurological Surgery | Allopathic & Osteopathic Physicians |
| Street Address |
498 ESSEX ST SUITE 104 |
| City | BANGOR |
| State | ME |
| Zip Code | 04401-3990 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801140660 | Spectrum Medical Group, P.a. | Psychiatry & Neurology | 498 Essex St, Suite 105, Bangor, ME 04401-3990 | 2012-11-01 |
| 1316225923 | Suzanne Bourque | Psychiatry & Neurology | 498 Essex St, Suite 105, Bangor, ME 04401-3990 | 2011-07-31 |
| 1770888547 | John Thomas Hauge | Dentist | 498 Essex St, #103, Bangor, ME 04401-3990 | 2011-01-25 |
| 1457520827 | Neurologic Diagnostic Services of Eastern Maine, P.a. | Physiological Laboratory | 498 Essex St, Bangor, ME 04401-3990 | 2008-02-29 |
| 1346439767 | Sally E K Kirkpatrick | Psychiatry & Neurology | 498 Essex St, Bangor, ME 04401-3990 | 2007-10-22 |
| 1093900441 | Mirna Hajjar | Psychiatry & Neurology | 498 Essex St, Suite 105, Bangor, ME 04401-3990 | 2007-09-10 |
| 1922292945 | Markos Poulopoulos | Psychiatry & Neurology | 498 Essex St, Suite 105, Bangor, ME 04401-3990 | 2007-09-03 |
| 1578601993 | Francis I Kittredge Jr. | Psychiatry & Neurology | 498 Essex St, Bangor, ME 04401-3990 | 2007-02-01 |
| 1356496244 | Holden Dental Center, P.a. | Clinic/Center | 498 Essex St, #103, Bangor, ME 04401-3990 | 2007-01-24 |
| 1811919269 | James W Sears | Psychiatry & Neurology | 498 Essex St, Suite 105, Bangor, ME 04401-3990 | 2006-07-24 |
| Find all providers in the same location | ||||
| 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 | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447248802 | James W Turner | Neurological Surgery | 417 State St Ste 221, Bangor, ME 04401-6630 | 2005-10-10 |
| 1689104234 | Michael Paci | Neurological Surgery | 417 State St Ste 221, Bangor, ME 04401 | 2017-06-15 |
| 1881968543 | Rudolph Daniel Marciano IIi | Neurological Surgery | 417 State Street, Webber East, Ste 221, Bangor, ME 04401 | 2012-02-28 |
| 1730479817 | Michael Cohen | Neurological Surgery | 417 State St Ste 221, Bangor, ME 04401-6630 | 2011-04-11 |
| 1760618862 | James M Macnutt | Neurological Surgery | 417 State Street, Webber East Building Suite 221, Bangor, ME 04401 | 2009-06-03 |
| 1457528010 | Mahmoud Hamdy Ibrahim Kamel | Neurological Surgery | 489 State Street, Eastern Maine Medical Center / Dept. of Neurosurgery, Bangor, ME 04401 | 2008-05-13 |
| 1275626814 | Dennis Lee Shubert | Neurological Surgery | 404 State St, Suite 101, Bangor, ME 04401 | 2006-10-02 |
| 1689620775 | Joanna R Swartzbaugh | Neurological Surgery | 360 Broadway, Bangor, ME 04401-3979 | 2006-05-26 |
| 1891783254 | David M Weitman | Neurological Surgery | 360 Broadway, Bangor, ME 04401-3979 | 2005-10-10 |
| 1457359226 | Wayne Robert Waterman | Neurological Surgery | 417 State St, Suite 221, Bangor, ME 04401-6630 | 2005-07-14 |
| 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.