Individual
SCOTT K. WITHERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
246 CAMP RD, COOPER, ME 04657-3221
(207) 454-7693
(207) 454-0929
Mailing address
246 CAMP RD, COOPER, ME 04657
(207) 454-7693
(207) 454-0929
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA193
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
S2017
—
ME
Enumeration date
07/01/2006
Last updated
10/16/2007
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