Individual
MRS. ELIZABETH S LEVESQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
144 STATE ST, PORTLAND, ME 04101-3776
(207) 879-3049
Mailing address
144 STATE ST, PORTLAND, ME 04101-3776
(207) 879-3049
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-678
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30338040
—
NH
05
—
433851099
—
ME
01
—
P00395094
RAILROAD MEDICARE
ME
Enumeration date
05/31/2006
Last updated
07/29/2010
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