CHARLES D CLEMETSON (NPI# 1649448267) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649448267 |
| Entity Type | Individual |
| Full Name | CHARLES D CLEMETSON |
| Credential | M.D. |
| Practice Address |
39 Foreside Rd Portland ME 04110-1405 |
| Practice Telephone | 2074152700 |
| Practice Fax Number | 2078990138 |
| Mailing Telephone | 2074152700 |
| Mailing Fax Number | 2078990138 |
| Enumeration Date | 2008-02-17 |
| Last Update Date | 2011-06-24 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
013808 | ME | Allopathic & Osteopathic Physicians |
| N | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
013808 | ME | Allopathic & Osteopathic Physicians |
| Street Address |
39 FORESIDE RD |
| City | PORTLAND |
| State | ME |
| Zip Code | 04110-1405 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619305943 | Patricia Ruggles | Counselor | 62 Foreside Rd, Cumberland Foreside, ME 04110 | 2013-10-23 |
| 1679770408 | Brian C Green | Dentist | 269 Us Route One, Cumberland Foreside, ME 04110 | 2007-06-27 |
| 1518962596 | Elizabeth Knapp Kubik | Psychologist | 15 Wildwood Blvd, Cumberland Foreside, ME 04110-1211 | 2005-06-16 |
| 1912235730 | Lifetimesmiles LLC | Dental Hygienist | 3 Carriage Rd, Cumberland Foreside, ME 04110-1301 | 2009-12-07 |
| 1699134585 | Royal River Dental LLC | Dentist | 269 Us Route 1, Cumberland Foreside, ME 04110-1329 | 2016-02-19 |
| 1255488243 | Stephen M Redmond | Chiropractor | 269a Us Route One, Cumberland Foreside, ME 04110-1329 | 2007-01-04 |
| 1295967347 | Casco Bay Chiropractic, Pa. | Chiropractor | 269a Us Route One, Cumberland Foreside, ME 04110-1329 | 2009-08-21 |
| 1770530263 | Deborah Pepper-dougherty | Dietitian, Registered | 15 Sky View Dr, Cumberland Foreside, ME 04110-1339 | 2006-05-28 |
| 1871143909 | Rasha Y Hanafy, Do LLC | Family Medicine | 15 Sky View Dr, Cumberland Foreside, ME 04110-1339 | 2019-09-20 |
| 1639100548 | Michelle M Huntley | Dietitian, Registered | 15 Sky View Dr, Cumberland Foreside, ME 04110-1339 | 2006-07-06 |
| Find all providers in zip 04110 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447878947 | Celia Mantovani | Psychiatry & Neurology | 15 Cypress St, Portland, ME 04103-2008 | 2020-07-10 |
| 1538782834 | Endeavor Psychiatry LLC | Psychiatry & Neurology | Sw, Portland, OR 97219-5885 | 2020-05-20 |
| 1154942142 | Prisma Wellness LLC | Psychiatry & Neurology | 10260 Sw Greenburg Rd Fl 4, Portland, OR 97223-5500 | 2020-04-30 |
| 1588291082 | Alexis Family Psychiatry, LLC | Psychiatry & Neurology | 415 Congress St Ste 202a, Portland, ME 04101-3500 | 2020-03-24 |
| 1881188084 | Geriatric Psychiatry Associates | Psychiatry & Neurology | 123 Nw 12th Ave Apt 424, Portland, OR 97209-4145 | 2018-06-20 |
| 1982104063 | Carl Chi | Psychiatry & Neurology | 22 Goodrich Ln, Portland, CT 06480-1063 | 2018-02-15 |
| 1154839108 | Cascade Tms LLC | Psychiatry & Neurology | 205 Se Spokane St Ste 301, Portland, OR 97202-6487 | 2018-01-11 |
| 1538601737 | Diana S Domnitei Md LLC | Psychiatry & Neurology | 1012 Sw King Ave Ste 306, Portland, OR 97205-1110 | 2016-11-06 |
| 1104286269 | Anne Fleming, Md, LLC | Psychiatry & Neurology | 2340 Nw Thurman St Ste 202, Portland, OR 97210-2579 | 2016-03-02 |
| 1417338708 | Andrew Justin Ruege | Psychiatry & Neurology | 5421 Sw Patton Rd, Portland, OR 97221-2226 | 2015-06-12 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.