Individual
DR. JEFFREY L GRASSMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
100 FODEN RD, EAST, SUITE 203, SOUTH PORTLAND, ME 04106-2327
(207) 874-1489
(207) 523-8590
Mailing address
100 GANNETT DR STE C, SOUTH PORTLAND, ME 04106-5900
(207) 828-0361
(207) 874-1483
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2147
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1750580486
—
ME
Enumeration date
07/12/2007
Last updated
05/21/2018
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