Provider Demographics
NPI:1578665485
Name:BRUSHETT, DONALD G (MD)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:G
Last Name:BRUSHETT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:P.O. BOX 500
Mailing Address - Street 2:
Mailing Address - City:PATTEN
Mailing Address - State:ME
Mailing Address - Zip Code:04765-0500
Mailing Address - Country:US
Mailing Address - Phone:207-528-2285
Mailing Address - Fax:207-528-2880
Practice Address - Street 1:59 BANGOR STREET
Practice Address - Street 2:KATAHDIN VALLEY HEALTH CENTER
Practice Address - City:HOULTON
Practice Address - State:ME
Practice Address - Zip Code:04730
Practice Address - Country:US
Practice Address - Phone:207-528-2285
Practice Address - Fax:207-528-2880
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ME009207207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME301560099Medicaid
ME301560099Medicaid
MED0152576Medicare ID - Type Unspecified