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Individual

MATTHEW P BUREAU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
70 LINCOLN STREET, MILL 6, BATES MILL DERMATOLOGY, PLLC, LEWISTON, ME 04240
(207) 795-7540
(207) 795-7528
Mailing address
70 LINCOLN STREET, MILL 6, BATES MILL DERMATOLOGY, PLLC, LEWISTON, ME 04240
(207) 795-7540
(207) 795-7528

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
103496
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0219PA
SC
01
970030187
RAILROAD MEDICARE
NC
Enumeration date
07/20/2005
Last updated
02/04/2014
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