Individual
EMILY BLOSSOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
230 WATERMAN DR, SOUTH PORTLAND, ME 04106-3635
(207) 358-3188
Mailing address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 706-3280
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2182
ME
363A00000X
Physician Assistant
—
—
Other
Enumeration date
02/26/2019
Last updated
10/17/2023
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