Individual
BRONNA L ECKELMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
25A JUNE STREET, SANFORD, ME 04073
(207) 324-1488
Mailing address
1 MEDICAL CENTER DRIVE, BIDDEFORD, ME 04005
(207) 283-7000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0437 P
NH
363A00000X
Physician Assistant
PA7900
ME
363AS0400X
Surgical Physician Assistant
Primary
PA7900
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30332203
—
NH
Enumeration date
07/23/2006
Last updated
03/11/2019
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