Provider Demographics
NPI:1053581058
Name:LITTLEJOHN, FREDERICK CRAIG (MD)
Entity type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:CRAIG
Last Name:LITTLEJOHN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:F
Other - Middle Name:CRAIG
Other - Last Name:LITTLEJOHN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:25 CHESTNUT LN
Mailing Address - Street 2:
Mailing Address - City:YARMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04096-8442
Mailing Address - Country:US
Mailing Address - Phone:207-835-8116
Mailing Address - Fax:
Practice Address - Street 1:1945 CONGRESS ST STE 103
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04102-1967
Practice Address - Country:US
Practice Address - Phone:207-835-8116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-05
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY240775207LP2900X
MEEL111002207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME165237ZELVMedicare PIN
MD165237ZELVMedicare PIN