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Individual

MR. PHILIP C GAGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
180 PARK AVE, PORTLAND, ME 04102-2957
(207) 874-2141
(207) 874-2164
Mailing address
180 PARK AVE, PORTLAND, ME 04102-2957
(207) 874-2141
(207) 874-2164

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
A094979
IA
363LF0000X
Family Nurse Practitioner
Primary
CNP81900
ME
363LF0000X
Family Nurse Practitioner
R054840
ME

Other

Enumeration date
10/02/2006
Last updated
12/04/2017
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