Individual
LYNNE M TETREAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5 SCAMMAN ST., SACO, ME 04072
(207) 282-3327
Mailing address
301C US ROUTE 1, SCARBOROUGH, ME 04074-9701
(207) 396-8600
(207) 396-8632
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD14722
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
268810099
—
ME
Enumeration date
10/05/2006
Last updated
08/24/2012
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