Individual
LISA F DEWOLFE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6 E CHESTNUT ST, AUGUSTA, ME 04330-5717
(207) 623-1303
Mailing address
6 E CHESTNUT ST, AUGUSTA, ME 04330-5717
(207) 623-1303
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-268
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
287370099
—
ME
Enumeration date
06/05/2006
Last updated
06/28/2010
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