Most Relevant Information
Provider Data
NPI Number: | 1003403353 |
Provider Name: | JOHN MICHAEL RUTLEDGE PA-C |
Entity Type: | Individual |
Taxonomy Code: | 363AS0400X |
Specialty: | Physician Assistant |
License Number: | PA2259 |
Most Important Dates
Enumeration Date: | 12/21/2020 |
Last Updated: | 11/08/2021 |
Provider Practice Location
417 STATE STREET
WEBBER WEST SUITE 340
BANGOR
ME
04401
Practice Location Phone/Fax
Phone: | 2079734949 |
Fax: | 2079734466 |
Provider Mailing Location
43 WHITING HILL RD STE 300
BREWER
ME
044121006
Provider Mailing Phone/Fax
Phone: | 2079734949 |
Fax: | 2079734466 |