# PORTLAND GASTROENTEROLOGY ASSOCIATES P.A.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508087289
- **Authorized official:** MELISSA GOUSSE (PRACTICE ADMINISTRATOR)
- **Authorized official phone:** (207) 773-7964

## Contact information

- **Practice address:** 161 MARGINAL WAY, PORTLAND, ME 04101
- **Practice address phone:** (207) 773-7964
- **Practice address fax:** (207) 773-9073
- **Mailing address:** 161 MARGINAL WAY, PORTLAND, ME 04101-2438
- **Mailing address phone:** (207) 773-7964
- **Mailing address fax:** (207) 773-9073

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RG0100X | Gastroenterology Physician | — | NULL | Yes |
| 207RG0100X | Gastroenterology Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/01/2007
- **Last updated:** 02/03/2023