Individual
WESLEY SULLOWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
46 BARRA RD STE 103, BIDDEFORD, ME 04005-9461
(207) 283-1126
(207) 294-3544
Mailing address
46 BARRA RD STE 103, BIDDEFORD, ME 04005-9461
(207) 283-1126
(207) 294-3544
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA2426
ME
363AS0400X
Surgical Physician Assistant
Primary
PA2426
ME
Other
Enumeration date
08/12/2022
Last updated
05/01/2025
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