Individual
BROOKE K MADEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
96 CAMPUS DR, SUITE 1, SCARBOROUGH, ME 04074-7163
(207) 885-9905
(207) 396-5600
Mailing address
190 RIVERSIDE ST, SUITE 6B, PORTLAND, ME 04103-1073
(207) 661-2000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085.004394
IL
363A00000X
Physician Assistant
Primary
PA1586
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1346599958
—
ME
Enumeration date
08/29/2012
Last updated
04/25/2017
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