Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
THEODORE J PETTENGILL, PA
ActiveTHEODORE J PETTENGILL, PA is a Physician Assistant healthcare provider located in SHERMAN, Maine. NPI 1033187596 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · SHERMAN, ME
Registration Details
- NPI Number
- 1033187596
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Mar 10, 2006 (20.406009550864 yrs)
- Last Updated
- May 21, 2013
- Licenses
-
PA048 (ME)PA48 (ME)
Practice Information
- Address
-
226 MAIN STREETSHERMAN, ME, 047760000Browse ME providers · Browse ZIP 04776
- Phone
- 2073654335
- Fax
- 2073654336
- Primary Specialty
-
Physician Assistant
363A00000X
- Additional Specialty
- Physician Assistant
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.