Provider Demographics
NPI:1790770774
Name:GELINAS, WILLIAM A (PA-C)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:A
Last Name:GELINAS
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:78 ATLANTIC PL
Mailing Address - Street 2:
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-2316
Mailing Address - Country:US
Mailing Address - Phone:207-661-6654
Mailing Address - Fax:207-842-7773
Practice Address - Street 1:123 ANDOVER ROAD
Practice Address - Street 2:
Practice Address - City:WESTBROOK
Practice Address - State:ME
Practice Address - Zip Code:04092-3848
Practice Address - Country:US
Practice Address - Phone:207-761-2200
Practice Address - Fax:207-761-2108
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2016-10-25
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Provider Licenses
StateLicense IDTaxonomies
MEPA667363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MES78513Medicare UPIN
MEAP1247Medicare PIN