Individual
AMEENA FAUQ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1 NORTHEAST DR, BANGOR, ME 04401-4332
(904) 536-6626
Mailing address
43 WHITING HILL RD STE 300, BREWER, ME 04412-1006
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA1844
ME
Other
Enumeration date
07/20/2018
Last updated
03/03/2021
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