Individual
TINA G MERRILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-2263
(207) 741-8121
Mailing address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-2263
(207) 741-8121
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA 687
ME
Other
Enumeration date
05/04/2006
Last updated
05/16/2012
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