STACEY LEA ANDERSON MD NPI 1710990775

NPI Information

NPI: 1710990775
Provider Name: STACEY LEA ANDERSON, MD
Classification: Obstetrics & Gynecology - 207V00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
46 FAIRVIEW AVE STE 229
SKOWHEGAN, ME
ZIP 04976
Phone: (207) 474-7131
Get Directions

Stacey Lea Anderson, MD is an obstetrics gynecology in Skowhegan, ME. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. Stacey Lea Anderson, MD NPI is 1710990775. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

46 FAIRVIEW AVE STE 229
SKOWHEGAN, ME
ZIP 04976-481
Phone: (207) 474-7131
Fax: (207) 474-3998

The NPI 1710990775 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/14/2006 and was last updated on 10/18/2021.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207VX0000X	Obstetrics & Gynecology	Obstetrics	5227	ALASKA	No
2	207VX0000X	Obstetrics & Gynecology	Obstetrics	MD22365	MAINE	No
3	207VX0000X	Obstetrics & Gynecology	Obstetrics	EL181026	MAINE	No
4	207V00000X	Obstetrics & Gynecology		60858413	WASHINGTON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1710990775	MEDICAID	MAINE

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: 11/14/2023

NPI Synchronization or Removal

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