Petrus, Jaime L
Petrus, Jaime L is an individual health care provider with primary practice located at 22 Bramhall St Pavilion 1203, Portland ME 04102. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Petrus, Jaime L can be contacted via phone (207) 662-4618.Contact Information
Primary practice address
22 Bramhall St Pavilion 1203
Portland ME 04102
Phone: (207) 662-4618
Fax: (207) 662-6254
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 017196 | Maine |
Profile Details
| NPI number | 1891881447 |
|---|---|
| LBN Legal business name | Petrus, Jaime L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 4th, 2006 |
| Last updated | Feb 23rd, 2009 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1891881447 | NPPES |
| New Hampshire | MEDICAID | 30206869 | |
| New Hampshire | MEDICAID | 432616699 |
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