Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 57286 | MN |
N | 208800000X | Urologist | MD23852 | ME |
NPI | 1053577197 |
---|---|
Provider Name | Dr. Maria Alexandra Ordonez |
First Address | South Portland, ME 04106 |
Second Address | South Portland, ME 04106-1999 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2008 |
Last Update Date | 13/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1053577197 | HEALTHPARTNERS (01) | MN |
1053577197 | PREFERRED ONE (01) | MN |
57286 | MINNESOTA MEDICAL LICENSE (01) | MN |
H400105537 | (02) | MN |