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NPI Code Detail

MEDICARE: JAMES D POTTEIGER PA-C

MEDICARE:   JAMES D POTTEIGER  PA-C
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 AssistantPA-617ME

General Provider Information

NPI Number : 1861437857
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES D POTTEIGER PA-C
Provider Business Mailing Address
First Line : 117 AUBURN ST
Second Line :
City : PORTLAND
State : ME
Zip : 04103-6003
Country : US
Telephone Number : 207-797-4445
Fax Number :
Provider Business Practice Location Address
First Line : 117 AUBURN ST
Second Line :
City : PORTLAND
State : ME
Zip : 04103-6003
Country : US
Telephone Number : 207-797-4445
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2006
Last Update Date : 07/08/2007

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Directions to “ JAMES D POTTEIGER PA-C” Practice Location

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