Provider Demographics
NPI:1225072226
Name:HULL, FRANK A (PA-C)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:A
Last Name:HULL
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 FORE RIVER PKWY
Mailing Address - Street 2:SUITE 490
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04102-2780
Mailing Address - Country:US
Mailing Address - Phone:207-553-6054
Mailing Address - Fax:207-553-6076
Practice Address - Street 1:195 FORE RIVER PKWY
Practice Address - Street 2:SUITE 490
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04102-2780
Practice Address - Country:US
Practice Address - Phone:207-553-6054
Practice Address - Fax:207-553-6076
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPS-229363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30336258Medicaid
ME315190099Medicaid
MEP00709644Medicare PIN
MES31613Medicare UPIN
MEAP0435Medicare PIN
MEAP043501Medicare PIN
MEAP043502Medicare PIN
MEAP043503Medicare PIN