| Jeffrey M Halter, MD | |
|
887 Congress St, Suite 300, Portland, ME 04102 | |
| (207) 662-5555 | |
| (207) 662-5526 |
| Full Name | Jeffrey M Halter |
|---|---|
| Gender | Male |
| Speciality | Surgery - Pediatric Surgery |
| Location | 887 Congress St, Portland, Maine |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720297849 | NPI | - | NPPES |
| 30207763 | Medicaid | NH | |
| 432923399 | Medicaid | ME |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2086S0120X | Surgery - Pediatric Surgery | 017790 (Maine) | Secondary |
| 2086S0120X | Surgery - Pediatric Surgery | 35-089504 (Ohio) | Primary |
| Entity Name | Maine Medical Partners |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1134144090 PECOS PAC ID: 9335043967 Enrollment ID: O20040331000191 |
| 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 |
|---|---|
| Jeffrey M Halter, MD 301 Us Route 1, Building C, Scarborough, ME 04074-9701 Ph: (207) 396-8600 | Jeffrey M Halter, MD 887 Congress St, Suite 300, Portland, ME 04102 Ph: (207) 662-5555 |
Virginia A Eddy, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 887 Congress St., Portland, ME 04102 Phone: 207-774-2311 | |
Leslie S Wu, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 887 Congress St, Suite 400, Portland, ME 04102 Phone: 207-774-6368 Fax: 207-774-9388 | |
Dr. Benjamin Lincoln Russell, DO Surgery Medicare: Not Enrolled in Medicare Practice Location: 195 Fore River Pkwy, Suite 420, Portland, ME 04102 Phone: 207-553-6500 Fax: 207-553-6520 | |
Dr. Forest Raymond Sheppard, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 887 Congress St Ste 210, Portland, ME 04102 Phone: 207-774-6368 Fax: 207-774-9388 | |
Dr. Stacey Anne Rotta, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 887 Congress St, Portland, ME 04102 Phone: 207-774-6368 | |
Dr. Laura Teresa Withers, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 887 Congress St Ste 210, Portland, ME 04102 Phone: 207-774-2381 | |
Dr. Daniel C. Cullinane, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 887 Congress St Ste 210, Portland, ME 04102 Phone: 207-774-2381 |