Individual
MR. MICHAEL ALLEN NORTHWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
20 HARTFORD ST, HOULTON, ME 04730-1891
(207) 532-2900
(207) 532-5974
Mailing address
20 HARTFORD ST, HOULTON, ME 04730-1891
(207) 532-2900
(207) 532-5974
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R082308
GA
367500000X
Certified Registered Nurse Anesthetist
Primary
AA083105
ME
Other
Enumeration date
08/01/2005
Last updated
02/28/2014
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