Individual
MEGAN SOUTHWICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
91 CAMPUS AVE, LEWISTON, ME 04240
(207) 777-8120
(207) 777-8984
Mailing address
PO BOX 7291, LEWISTON, ME 04243-7291
(207) 777-8950
(207) 777-8800
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0972
NH
363A00000X
Physician Assistant
PA300
ME
363A00000X
Physician Assistant
PAN300
ME
363AM0700X
Medical Physician Assistant
Primary
PA300
ME
Other
Enumeration date
08/04/2009
Last updated
06/09/2022
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