Individual
SAMUEL EMERSON HAZARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
22 BRAMHALL ST RM 2218, PORTLAND, ME 04102-3134
(207) 662-5610
Mailing address
22 BRAMHALL ST RM 2218, PORTLAND, ME 04102-3134
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA376
ME
363AM0700X
Medical Physician Assistant
—
MA
Other
Enumeration date
06/10/2013
Last updated
01/07/2020
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