Individual
MATTHEW P GUILBEAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1601 CONGRESS ST, PORTLAND, ME 04102-2102
(207) 774-5113
(207) 874-0320
Mailing address
1601 CONGRESS ST, PORTLAND, ME 04102-2102
(207) 774-5113
(207) 874-0320
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA001078
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
098980
ANTHEM BCBS
ME
Enumeration date
08/30/2006
Last updated
03/07/2023
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