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Individual

ROBERT J POOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
119 GANNETT DR, SOUTH PORTLAND, ME 04106-6942
(207) 774-2642
(207) 774-4293
Mailing address
301C US ROUTE ONE, SCARBOROUGH, ME 04074-9701
(207) 396-8600
(207) 396-8632

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA635
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30339347
NH
Enumeration date
07/18/2011
Last updated
11/26/2014
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