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FORE RIVER UROLOGY LLC NPI 1003248436


NPI Information

NPI: 1003248436
Provider Name: FORE RIVER UROLOGY LLC
Classification: Urology - 208800000X
Entity Type: Organization

CLIA Number: 20D2065370

Address:
21 DONALD B DEAN DR
SUITE 1
SOUTH PORTLAND, ME
ZIP 04106
Phone: (207) 776-2411
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FORE RIVER UROLOGY LLC is an urology in South Portland, ME. The provider is a urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. FORE RIVER UROLOGY LLC NPI is 1003248436. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

21 DONALD B DEAN DR
SUITE 1
SOUTH PORTLAND, ME
ZIP 04106-252
Phone: (207) 776-2411

The provider's authorized official is Megan Shorey .
The authorized official title is Office Manager and has the following contact phone number (207) 776-2411.

The CLIA number assigned to this NPI record is 20D2065370 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 8/8/2013 and was last updated on 8/8/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12088F0040XUrologyFemale Pelvic Medicine and Reconstructive SurgeryNo
22088P0231XUrologyPediatric UrologyNo
3208800000XUrologyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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