Basic Information
| Provider Information | |||||||||
| NPI: | 1023027539 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LAMHUT | ||||||||
| FirstName: | PENNY | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1599 | ||||||||
| Address2: | |||||||||
| City: | BANGOR | ||||||||
| State: | ME | ||||||||
| PostalCode: | 044021599 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2079455247 | ||||||||
| FaxNumber: | 2079470435 | ||||||||
| Practice Location | |||||||||
| Address1: | 9 ALUMNI DR | ||||||||
| Address2: | |||||||||
| City: | ORONO | ||||||||
| State: | ME | ||||||||
| PostalCode: | 044733479 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2079455247 | ||||||||
| FaxNumber: | 2074048351 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/05/2006 | ||||||||
| LastUpdateDate: | 04/16/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 015959 | ME | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 300270099 | 05 | ME | MEDICAID | 010474554 | 01 | ME | MEDNET | OTHER | M1741800 | 01 | ME | CGINA | OTHER | 044425 | 01 | ME | ANTHEM BC BS | OTHER | 3002487 | 01 | ME | AETNA | OTHER | 71822 | 01 | ME | HARVARD PILGRIM | OTHER |