Provider Demographics
NPI:1407830508
Name:GRIGEL, LINDA S (PAC)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:S
Last Name:GRIGEL
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 ROUTE 1
Mailing Address - Street 2:SUITE 203
Mailing Address - City:FALMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04105-1327
Mailing Address - Country:US
Mailing Address - Phone:207-781-7880
Mailing Address - Fax:207-781-7882
Practice Address - Street 1:202 ROUTE 1
Practice Address - Street 2:SUITE 203
Practice Address - City:FALMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04105-1327
Practice Address - Country:US
Practice Address - Phone:207-781-7880
Practice Address - Fax:207-781-7882
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPA308363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
79145597OtherAETNA
022397OtherANTHEM BCBS
ME282190099Medicaid
2545615OtherCIGNA
C66296OtherHARVARD PILGRIM
ME282190099Medicaid