Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Black Dog Medical PA

Organization Internal Medicine Physician · NPI 1154784668

Black Dog Medical PA is an Internal Medicine Physician in Lamoine, Maine. Licensed in Maine. Registered with an NPI since 2016.

Licensed in
ME
In the registry since
2016
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

11 Madison Ave
Lamoine, ME 04605
Phone: (207) 200-1464
Fax: (207) 805-8421
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence MD14569 (ME)

Record details

NPI number1154784668
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Patricia Wyshak — Owner · (207) 200-1464
NPI enumeratedApril 1, 2016
Last updated in NPPESApril 1, 2016
Mailing address11 Madison Avenue, Lamoine, ME 04605

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