Organization · NPI-2

Casco Medical Group

Obstetrics & Gynecology · Portland, ME

NPI number1205924594
StatusActive
Last updated in NPPESDec 1, 2014

Details

NPI
1205924594
Entity type
Organization (NPI-2)
Legal business name
Casco Medical Group
Organization subpart
No
Enumeration date
Oct 11, 2006
Last updated
Dec 1, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207V00000X Obstetrics & GynecologyMD12923MEYes
174400000X Specialist––
367A00000X Advanced Practice MidwifeAM082082ME
1041C0700X Social Worker, ClinicalLC5507ME

Practice location

535 Ocean Ave
Suite 2 - Second Floor
Portland, ME 04103

Phone 207-518-6000 · Fax 207-518-6001

Mailing address

535 Ocean Ave
Suite 2 - Second Floor
Portland, ME 04103

Phone 207-518-6000 · Fax 207-518-6001

Authorized official

Charles T Rainville
President
2075186041

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