| Dr Thaddeus T Shattuck, MD | |
|
330 Sabattus St Ste A, Lewiston, ME 04240-5553 | |
| (207) 777-8959 | |
| (207) 753-3093 |
| Full Name | Dr Thaddeus T Shattuck |
|---|---|
| Gender | Male |
| Speciality | Psychiatry |
| Experience | 21 Years |
| Location | 330 Sabattus St Ste A, Lewiston, Maine |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285798447 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084S0012X | Psychiatry & Neurology - Sleep Medicine | MD18527 (Maine) | Secondary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 018527 (Maine) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| St Mary's Regional Medical Center | Lewiston, ME | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| St Marys Regional Medical Center | 0042107120 | 178 |
| Mainehealth | 7517860588 | 2288 |
| Entity Name | St Marys Regional Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1447226584 PECOS PAC ID: 0042107120 Enrollment ID: O20040303000236 |
| Entity Name | Mainehealth |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1790265502 PECOS PAC ID: 7517860588 Enrollment ID: O20040701000166 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Thaddeus T Shattuck, MD 165 Lancaster St, Portland, ME 04101-2406 Ph: (207) 874-1030 | Dr Thaddeus T Shattuck, MD 330 Sabattus St Ste A, Lewiston, ME 04240-5553 Ph: (207) 777-8959 |
Ashley Beaulieu, Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 93 Campus Ave, Lewiston, ME 04240 Phone: 207-440-5902 | |
Alfonso Corona, M.D Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 1155 Lisbon St, Lewiston, ME 04240 Phone: 207-783-9141 | |
Dr. Paula Claire Kirby-long, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 76 High St Ste 300, Lewiston, ME 04240 Phone: 207-795-5544 Fax: 207-795-5645 | |
Dr. David A Dettmann, DO Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 100 Campus Ave, Suite 208, Lewiston, ME 04240 Phone: 207-777-8974 Fax: 207-777-8946 | |
Dr. Luke W Ballenger Iii, MD Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 100 Campus Ave, Suite 208, Lewiston, ME 04240 Phone: 207-777-8974 Fax: 207-777-8946 | |
Katelyn Ellen Martin, Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 93 Campus Ave, Lewiston, ME 04240 Phone: 207-777-4455 | |
Dr. Annabel L Bradford, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 18 Mollison Way, Lewiston, ME 04240 Phone: 207-503-6693 |