Individual
AMY SANTERIAN BOUTSELIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-4078
Mailing address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-4078
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA2604
ME
363AS0400X
Surgical Physician Assistant
Primary
PA2604
ME
Other
Enumeration date
09/19/2022
Last updated
06/30/2025
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