Individual
CODY MAUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
818 CONGRESS ST, PORTLAND, ME 04102-3112
(207) 773-8161
Mailing address
8 SIMONTON ST, SOUTH PORTLAND, ME 04106-3132
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
PA1645
ME
363AS0400X
Surgical Physician Assistant
Primary
PA1645
ME
Other
Enumeration date
09/09/2016
Last updated
07/23/2024
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