Individual
MS. SHARON LYNN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1250 FOREST AVE, PORTLAND, ME 04103-1884
(207) 878-3177
Mailing address
111 LONGVIEW DR, PORTLAND, ME 04103-2282
(207) 232-6046
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA860
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA161
OSTEOPATHIC LISENCE
ME
Enumeration date
02/05/2007
Last updated
07/08/2007
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