Provider Demographics
NPI:1750340154
Name:LOCKWOOD, CATHERINE ANNE (MD)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ANNE
Last Name:LOCKWOOD
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 1:40 PARK RD
Mailing Address - Street 2:
Mailing Address - City:WESTBROOK
Mailing Address - State:ME
Mailing Address - Zip Code:04092-3188
Mailing Address - Country:US
Mailing Address - Phone:207-857-8174
Mailing Address - Fax:207-857-8410
Practice Address - Street 1:40 PARK RD
Practice Address - Street 2:
Practice Address - City:WESTBROOK
Practice Address - State:ME
Practice Address - Zip Code:04092-3188
Practice Address - Country:US
Practice Address - Phone:207-857-8174
Practice Address - Fax:207-857-8410
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME016180207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA33608OtherHNE
MA04-3194547OtherNORTHEAST HEALTH DIRECT
MA04-3194547OtherPLAN VISTA
MA3406385OtherAETNA
MA467411OtherTUFTS
MA2034425Medicaid
MA3090904001OtherCIGNA
MA04-3194547OtherGREAT-WEST
MA04-3194547OtherNORTHEAST HEALTHCARE ALLI
MA04-3194547OtherPHCS
MA04-3194547OtherUNICARE/GIC
MA04-3194547OtherUNITED HEALTHCARE
MAJ26742OtherBCBSMA
MA000000027006OtherBMC
MA04-3194547OtherCONSOLIDATED
MA04-3194547OtherNORTH AMERICAN PREFERRED
MA219287OtherCONNECTICARE
ME432275799Medicaid
MAAA5143OtherHARVARD PILGRIM
MA04-3194547OtherUNITED HEALTHCARE
MAAA5143OtherHARVARD PILGRIM