Provider Demographics
NPI:1730258054
Name:SHARE, CATHERINE A (MD)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:A
Last Name:SHARE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005-9422
Mailing Address - Country:US
Mailing Address - Phone:207-282-9080
Mailing Address - Fax:207-284-2631
Practice Address - Street 1:9 HEALTHCARE DR
Practice Address - Street 2:SUITE 204
Practice Address - City:BIDDEFORD
Practice Address - State:ME
Practice Address - Zip Code:04005-9449
Practice Address - Country:US
Practice Address - Phone:207-284-2630
Practice Address - Fax:207-284-2631
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD17260208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME432381199Medicaid
NH30207578Medicaid
MEME227401Medicare PIN
MEP00750452Medicare PIN
MEME2274Medicare PIN
MEE93860Medicare UPIN
NH30207578Medicaid