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NPI Code Detail

MEDICARE: GALE C TINKER PA

MEDICARE: GALE C TINKER PA
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
1363A00000XPhysician AssistantPA219ID
2363A00000XPhysician AssistantPA642ME

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000010136926OTHERIDREGENCE BLUE SHIELD OF ID
2PASG4OTHERIDBLUE CROSS OF ID

General Provider Information

NPI Number : 1841282951
Entity Type Code : Individual
Provider Name (Legal Business Name) : GALE C TINKER PA
Provider Business Mailing Address
First Line : 43 WHITING HILL RD
Second Line : SUITE 300
City : BREWER
State : ME
Zip : 04412-1005
Country : US
Telephone Number : 207-973-5035
Fax Number : 207-973-5042
Provider Business Practice Location Address
First Line : 489 STATE ST
Second Line : VASCULAR CARE OF MAINE
City : BANGOR
State : ME
Zip : 04401-6616
Country : US
Telephone Number : 207-973-6670
Fax Number : 207-973-5226
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2005
Last Update Date : 04/08/2008

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Directions to “ GALE C TINKER PA” Practice Location

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