Donnelly, Stephen M
Donnelly, Stephen M is an individual health care provider with primary practice located at 582 Roosevelt Trail , Windham ME 04062-4904. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Donnelly, Stephen M can be contacted via phone (207) 892-3233.Contact Information
Primary practice address
582 Roosevelt Trail
Windham ME 04062-4904
Phone: (207) 892-3233
Fax: (207) 893-0752
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 1581 | Maine |
Profile Details
| NPI number | 1063505782 |
|---|---|
| LBN Legal business name | Donnelly, Stephen M |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 2nd, 2006 |
| Last updated | Jun 12th, 2012 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1063505782 | NPPES |
| Maine | MEDICAID | 254690099 | |
| Maine | MEDICAID | 30226080 |
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