Provider Demographics
NPI:1023323359
Name:CASE, MICHAEL G (PA)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:G
Last Name:CASE
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:110 FREE ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04101-3576
Mailing Address - Country:US
Mailing Address - Phone:207-661-1025
Mailing Address - Fax:207-810-2407
Practice Address - Street 1:110 FREE ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101-3576
Practice Address - Country:US
Practice Address - Phone:207-661-1025
Practice Address - Fax:207-810-2407
Is Sole Proprietor?:No
Enumeration Date:2010-08-11
Last Update Date:2023-09-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MEPA1233363A00000X
MEPA001233363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant