Individual
MICHELLE PATRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MT
Contact information
Practice address
1 CITY CTR, PORTLAND, ME 04101-6420
(207) 773-7788
(207) 773-7711
Mailing address
1 CITY CTR, PORTLAND, ME 04101-6420
(207) 773-7788
(207) 773-7711
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MT1147
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
099403
ANTHEM BLUE CROSS BLUE SH
ME
Enumeration date
07/10/2007
Last updated
07/10/2007
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