Poor, Robert J

Poor, Robert J is an individual health care provider with primary practice located at 119 Gannett Dr , South Portland ME 04106-6942. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Poor, Robert J can be contacted via phone (207) 774-2642.

Contact Information

Primary practice address
119 Gannett Dr South Portland ME 04106-6942
Phone: (207) 774-2642
Fax: (207) 774-4293
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA635 Maine

Profile Details

NPI number 1184912677
LBN Legal business name Poor, Robert J
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 18th, 2011
Last updated Nov 26th, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184912677 NPPES
New Hampshire MEDICAID 30339347

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