Healthcare Provider Details

I. General information

NPI: 1427831767
Provider Name (Legal Business Name): TROY RICHARD CLOUTIER PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2023
Last Update Date: 05/12/2025
Certification Date: 05/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 HEALTHCARE DR STE 105
BIDDEFORD ME
04005-9445
US

IV. Provider business mailing address

9 HEALTHCARE DR STE 105
BIDDEFORD ME
04005-9445
US

V. Phone/Fax

Practice location:
  • Phone: 207-282-3666
  • Fax: 207-294-3552
Mailing address:
  • Phone: 207-282-3666
  • Fax: 207-294-3552

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA2548
License Number StateME

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: