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1720243678
MARK A DEBIASIO
SOUTH PORTLAND, ME
NPI
1720243678
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AS0400X Physician Assistant, Surgical
(Licence: ME PA1239)
Enumeration Date
2008-07-21
Last Update Date
2024-04-15
Business Address
MARK A DEBIASIO PA-C
119 GANNETT DR
SOUTH PORTLAND, ME 04106-6942
Phone number: 207-773-0040
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Mailing Address
MARK A DEBIASIO PA-C
190 RIVERSIDE ST SUITE 6B
PORTLAND, ME 04103-1073
Phone number: 207-661-2000
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