Individual
JOHN F CASSIDY IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
30 BOYNTON ST, EASTPORT, ME 04631-1306
(207) 853-6001
Mailing address
30 BOYNTON ST, EASTPORT, ME 04631-1306
(207) 853-6001
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA389
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
259290099
—
ME
01
—
MM9086
MEDICARE GROUP NUMBER
ME
Enumeration date
09/13/2006
Last updated
02/04/2026
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