Provider Demographics
NPI:1073592283
Name:WYMAN, PEGGY D (MD)
Entity type:Individual
Prefix:
First Name:PEGGY
Middle Name:D
Last Name:WYMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:180 CHURCH HILL RD STE 1
Mailing Address - Street 2:
Mailing Address - City:LEEDS
Mailing Address - State:ME
Mailing Address - Zip Code:04263-3418
Mailing Address - Country:US
Mailing Address - Phone:207-524-3501
Mailing Address - Fax:207-524-2093
Practice Address - Street 1:11 ACADEMY RD
Practice Address - Street 2:
Practice Address - City:MONMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04259-7035
Practice Address - Country:US
Practice Address - Phone:207-524-3501
Practice Address - Fax:207-933-9645
Is Sole Proprietor?:No
Enumeration Date:2006-01-16
Last Update Date:2025-07-29
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Provider Licenses
StateLicense IDTaxonomies
ME015145207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME248310099Medicaid
ME248310099Medicaid
MESX1629Medicare PIN
MEH32233Medicare UPIN