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Individual

MICHAEL G TRANFAGLIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
887 CONGRESS ST, SUITE 400, PORTLAND, ME 04102-3100
(207) 774-6368
(207) 774-9388
Mailing address
1600B CONGRESS ST, PORTLAND, ME 04102-2124
(207) 774-6368
(207) 774-9388

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
PA-395
ME
363AS0400X
Surgical Physician Assistant
Primary
PA-395
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
278950099
ME
01
970019234
RR MEDICARE
ME
Enumeration date
01/06/2006
Last updated
09/25/2017
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