Individual
JAMIE DUFOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
60 HIGH ST, LEWISTON, ME 04240-7616
(207) 753-3900
(207) 753-3902
Mailing address
60 HIGH ST, LEWISTON, ME 04240-7616
(207) 753-3900
(207) 753-3902
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA759
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
261600099
—
ME
Enumeration date
12/04/2006
Last updated
09/07/2010
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