Individual
PATRICIA LYNN WYSHAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
11 MADISON AVE, LAMOINE, ME 04605-4495
(207) 200-1464
(207) 805-8421
Mailing address
11 MADISON AVE, LAMOINE, ME 04605-4495
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
014569
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1041904
AETNA
ME
05
—
336800099
—
ME
01
—
MD14569
MEDICAL LICENSE
ME
Enumeration date
06/15/2006
Last updated
04/03/2024
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