Individual
SHADY ALY ISMAIL ELATTAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
62 W GRAY RD, GRAY, ME 04039-9772
(207) 657-2333
Mailing address
15 LEDGES CT, LEWISTON, ME 04240-1851
(207) 423-9986
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PR5603
ME
Other
Enumeration date
08/28/2009
Last updated
08/28/2009
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