Individual
MR. MIKEAL FREEDOM MERCEDES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RNFA
Contact information
Practice address
16 MEMORY LN, SOUTH PORTLAND, ME 04106-6148
(207) 632-9706
Mailing address
16 MEMORY LN, SOUTH PORTLAND, ME 04106-6148
(207) 632-9706
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
RN46450
ME
Other
Enumeration date
02/23/2012
Last updated
02/23/2012
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