Individual
MRS. EMILEE A. MASSIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-2414
(207) 662-6038
Mailing address
190 RIVERSIDE ST UNIT 6B, PORTLAND, ME 04103-1073
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
006120
GA
363A00000X
Physician Assistant
Primary
PA1843
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003112781A
—
GA
05
—
003112781B
—
GA
05
—
003112781C
—
GA
05
—
003112781D
—
GA
05
—
1229PA
—
SC
01
—
P00975462
RAILROAD MEDICARE
GA
01
—
P01112263
RAILROAD MEDICARE
GA
Enumeration date
08/05/2010
Last updated
09/11/2018
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