Provider Demographics
NPI:1831495852
Name:WARDWELL, RACHAEL M (PA-C)
Entity Type:Individual
Prefix:
First Name:RACHAEL
Middle Name:M
Last Name:WARDWELL
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:43 WHITING HILL RD STE 300
Mailing Address - Street 2:
Mailing Address - City:BREWER
Mailing Address - State:ME
Mailing Address - Zip Code:04412-1006
Mailing Address - Country:US
Mailing Address - Phone:207-973-9700
Mailing Address - Fax:
Practice Address - Street 1:1012 UNION ST
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-3060
Practice Address - Country:US
Practice Address - Phone:207-945-5247
Practice Address - Fax:207-947-0435
Is Sole Proprietor?:No
Enumeration Date:2011-02-09
Last Update Date:2017-05-04
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant