Individual
AMANDA ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
489 STATE ST, BANGOR, ME 04401-6674
(207) 973-7000
Mailing address
43 WHITING HILL RD STE 300, BREWER, ME 04412-1006
(207) 973-5000
(207) 973-5042
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9431
MA
363AM0700X
Medical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA2126
MAINE MEDICAL LICENSE NUMBER
ME
Enumeration date
09/09/2020
Last updated
07/20/2023
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