Individual
MADISON GRACE DOBECKI
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) 662-0111
Mailing address
818 CONGRESS ST, PORTLAND, ME 04102-3112
(207) 773-8161
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
PA2639
ME
363AS0400X
Surgical Physician Assistant
Primary
PA26399
ME
Other
Enumeration date
04/02/2024
Last updated
04/16/2024
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