Penobscot Valley Dermatology, P.A.
NPI 1952536880ActiveOrganization· Specialist· Bangor, ME
Specialist in Bangor, Maine, registered in NPPES in May 2009. The authorized official on file is Jeffrey Dean Pittis, MD, Dermatologist. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1952536880 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 21, 2009 |
| Last updated in NPPES | Jun 3, 2009 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Specialist Primary | 174400000X | ME013153 | ME |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (ME) |
|---|
Other Specialist providers in Bangor
- 1124185376
- 1194763110
- 1255667226
- 1003212648
- 1649544438
- 1295910479
- 1669525440
- 1205231651
- 1629112792
- 1508963877
- 1427338854
- 1508263112