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Individual

MR. HENRY CALVIN MARTENSEN III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
119 GANNETT DR, SOUTH PORTLAND, ME 04106-6942
(207) 781-1551
Mailing address
119 GANNETT DR, SOUTH PORTLAND, ME 04106-6942
(207) 661-2087
(207) 781-1552

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-06360
NC
363A00000X
Physician Assistant
PA2229
ME

Other

Enumeration date
04/08/2016
Last updated
07/16/2021
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