MMC DIABETES CONSULT SERVICE – NPI #1699076133
Internal Medicine

An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.

MMC DIABETES CONSULT SERVICE is a provider located in PORTLAND, ME. NPPES has assigned the NPI number 1699076133 to MMC DIABETES CONSULT SERVICE on November 16, 2010. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “MMC DIABETES CONSULT SERVICE” is a dba name, the actual legal business name for this organization is MAINEHEALTH. The primary taxonomy selected by this provider is 207RE0101X from the Health Care Provider Taxonomy code set, which is classified as Internal Medicine, specializing in Endocrinology, Diabetes & Metabolism

The NPI profile was previously updated about 6 years ago on May 11, 2020. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for MMC DIABETES CONSULT SERVICE below.

NPI Profile for
MAINEHEALTH

NPI Number
1699076133
Enumeration Date

(more than 15 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
MAINEHEALTH
Doing Business As (dba): MMC DIABETES CONSULT SERVICE
Primary location
22 BRAMHALL ST
PORTLAND, ME 04102
Phone: (207) 662-2651 Fax:
Mailing address
301 US ROUTE 1
BUILDING C
SCARBOROUGH, ME 04074-7609
Phone: (207) 396-8600 Fax: (207) 396-8632
Organization Subpart
No
Authorized Official
LUGENE INZANA
ASSOCIATE CFO
Phone: (207) 662-3538
Updated
Certification Date
May 11, 2020

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207RE0101X
- Internal Medicine / Endocrinology, Diabetes & Metabolism (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.