Individual
MINDY L PURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
690 MINOT AVENUE, AUBURN, ME 04210
(207) 783-1328
(207) 795-0260
Mailing address
324 GANNETT DRIVE SUITE 200, SOUTH PORTLAND, ME 04106
(207) 482-7800
(207) 956-6676
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA001264
ME
363AS0400X
Surgical Physician Assistant
PA9104404
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1386833317
—
ME
Enumeration date
10/16/2007
Last updated
08/24/2017
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