Individual
ANDREA K GROFT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
489 STATE ST, EMMC, EMERG. MEDICINE, BANGOR, ME 04401-6616
(207) 973-7250
(207) 973-5656
Mailing address
PO BOX 404, EMMC, EMERG. MEDICINE, BANGOR, ME 04402-0404
(207) 973-7250
(207) 973-5656
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA445
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1029057
NCCPA CERTIFICATE NUMBER
—
Enumeration date
08/23/2006
Last updated
05/13/2021
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