Provider Demographics
NPI:1225911647
Name:MMC ACO
Entity type:Organization
Organization Name:MMC ACO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FRED
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-939-6789
Mailing Address - Street 1:91 AUBURN ST STE J1096
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04103-6008
Mailing Address - Country:US
Mailing Address - Phone:207-518-8869
Mailing Address - Fax:207-888-3733
Practice Address - Street 1:335 BRIGHTON AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04102-2363
Practice Address - Country:US
Practice Address - Phone:207-518-8869
Practice Address - Fax:207-888-3733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-31
Last Update Date:2025-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty