Individual
JASON DAVID MUDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-2934
(207) 662-6389
Mailing address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-2934
(207) 662-6389
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA2402
ME
363AS0400X
Surgical Physician Assistant
Primary
PA2402
ME
Other
Enumeration date
06/18/2022
Last updated
01/05/2026
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