Individual
MR. HANS TORMOD GUNDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-4618
Mailing address
301 US ROUTE 1, BUILDING C, SCARBOROUGH, ME 04074-7609
(207) 396-8600
(207) 396-8632
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30338352
—
NH
Enumeration date
09/21/2006
Last updated
01/10/2011
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