| Moritz H Hansen, MD | |
|
100 Brickhill Avenue, South Portland, ME 04106 | |
| (207) 773-1728 | |
| (207) 772-4062 |
| Full Name | Moritz H Hansen |
|---|---|
| Gender | Male |
| Speciality | Urology |
| Location | 100 Brickhill Avenue, South 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 |
|---|---|---|---|
| 1649226655 | NPI | - | NPPES |
| 301640099 | Medicaid | ME | |
| 30200670 | Medicaid | NH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208800000X | Urology | 015054 (Maine) | Primary |
| Entity Name | Maine Medical Partners |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1598780447 PECOS PAC ID: 9335043967 Enrollment ID: O20040220000847 |
| 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 |
|---|---|
| Moritz H Hansen, MD 301 Us Route 1, Building C, Scarborough, ME 04074-7609 Ph: (207) 396-8600 | Moritz H Hansen, MD 100 Brickhill Avenue, South Portland, ME 04106 Ph: (207) 773-1728 |
Stephen Thomas Ryan, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 100 Brickhill Ave, South Portland, ME 04106 Phone: 207-773-1728 Fax: 207-773-8153 | |
Clark E Judge, MD Urology Medicare: Medicare Enrolled Practice Location: 100 Brickhill Ave Ste 201, South Portland, ME 04106 Phone: 207-773-1728 | |
Lily C Wang, M.D., PHD Urology Medicare: Medicare Enrolled Practice Location: 100 Brickhill Ave, South Portland, ME 04106 Phone: 207-773-1728 | |
Dr. Lisa T Beaule, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 100 Brickhill Ave, South Portland, ME 04106 Phone: 207-773-1728 Fax: 207-772-4062 | |
Dr. Sanchita Bose, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 100 Brickhill Ave, South Portland, ME 04106 Phone: 207-773-1728 | |
Brian M Jumper, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 100 Brickhill Avenue, South Portland, ME 04106 Phone: 207-773-1728 Fax: 207-772-4062 |