Most Relevant Information
Provider Data
| NPI Number: | 1003290313 |
| Provider Name: | MARY WHITE PA |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | PA1553 |
Most Important Dates
| Enumeration Date: | 07/16/2015 |
| Last Updated: | 04/08/2024 |
Provider Practice Location
543 BROADWAY
BANGOR
ME
044013337
Practice Location Phone/Fax
| Phone: | 2079221300 |
| Fax: | 2072176742 |
Provider Mailing Location
360 US HIGHWAY 1 BYP UNIT 102
PORTSMOUTH
NH
038017105
Provider Mailing Phone/Fax
| Phone: | 6034106700 |
| Fax: | 6033198308 |