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NPI Code Detail

MEDICARE: CLARE HUTCHINSON LOXTERKAMP

MEDICARE: CLARE HUTCHINSON LOXTERKAMP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician AssistantPA1513ME
2363A00000XPhysician AssistantPA1513ME

General Provider Information

NPI Number : 1063805703
Entity Type Code : Individual
Provider Name (Legal Business Name) : CLARE HUTCHINSON LOXTERKAMP
Provider Business Mailing Address
First Line : 22 BRAMHALL ST
Second Line :
City : PORTLAND
State : ME
Zip : 04102-3134
Country : US
Telephone Number : 207-662-4618
Fax Number : 207-662-6254
Provider Business Practice Location Address
First Line : 22 BRAMHALL ST
Second Line :
City : PORTLAND
State : ME
Zip : 04102-3134
Country : US
Telephone Number : 207-662-4618
Fax Number : 207-662-6254
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/05/2015
Last Update Date : 03/03/2026

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Directions to “ CLARE HUTCHINSON LOXTERKAMP ” Practice Location

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