Individual
SHELBY J SLAUENWHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
489 STATE ST STE 221, BANGOR, ME 04401-6616
(207) 973-9949
(207) 973-9555
Mailing address
43 WHITING HILL RD, BREWER, ME 04412-1005
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1484
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA1484
STATE LICENSE
ME
Enumeration date
09/02/2014
Last updated
03/07/2023
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