Provider Demographics
NPI:1205902400
Name:MAINE PLASTIC SURGICAL ASSOCIATES PA
Entity type:Organization
Organization Name:MAINE PLASTIC SURGICAL ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:L
Authorized Official - Last Name:SCHASSBERGER
Authorized Official - Suffix:I
Authorized Official - Credentials:MD
Authorized Official - Phone:207-873-4411
Mailing Address - Street 1:325D KENNEDY MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:WATERVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04901-4530
Mailing Address - Country:US
Mailing Address - Phone:207-873-4411
Mailing Address - Fax:207-872-5542
Practice Address - Street 1:325D KENNEDY MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:WATERVILLE
Practice Address - State:ME
Practice Address - Zip Code:04901-4530
Practice Address - Country:US
Practice Address - Phone:207-873-4411
Practice Address - Fax:207-872-5542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEMM8690Medicare ID - Type Unspecified