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Individual

BLUE B BUTTERFIELD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
22 BRAMHALL ST, PAVILION 1203, PORTLAND, ME 04102
(207) 662-4618
(207) 662-6254
Mailing address
301 US ROUTE 1, BUILDING C, SCARBOROUGH, ME 04074-7609
(207) 396-8600
(207) 396-8632

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA557
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30336248
NH
05
432593099
ME
Enumeration date
05/30/2006
Last updated
01/04/2011
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