Individual
MR. JUDE I TARDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
417 STATE ST, SUITE 330, BANGOR, ME 04401-6630
(207) 973-8881
(207) 973-8880
Mailing address
43 WHITING HILL RD STE 300, BREWER, ME 04412-1006
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA699
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
266110099
—
ME
Enumeration date
04/26/2006
Last updated
10/18/2017
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