Provider Demographics
NPI:1023140035
Name:GUITREAU, DARRIN PAUL (PA-C)
Entity type:Individual
Prefix:
First Name:DARRIN
Middle Name:PAUL
Last Name:GUITREAU
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 1:121 MEDICAL CENTER DR STE 3300
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-2674
Mailing Address - Country:US
Mailing Address - Phone:207-373-6490
Mailing Address - Fax:207-536-6046
Practice Address - Street 1:121 MEDICAL CENTER DR STE 3300
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-2674
Practice Address - Country:US
Practice Address - Phone:207-373-6490
Practice Address - Fax:207-536-6046
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA0003781363AM0700X
MEPA2184363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR147306Medicare PIN