Individual
JEYASHREE M BOARDWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
181 CORPORATE DR, BANGOR, ME 04401-4314
(207) 992-2636
(207) 992-2637
Mailing address
PO BOX 1599, BANGOR, ME 04402-1599
(207) 404-8200
(207) 947-0435
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1823
ME
Other
Enumeration date
06/21/2018
Last updated
08/19/2021
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