IndividualActive
Cody Mauch
NPI 1083161822 · Surgical Physician Assistant · Portland, ME
Provider details
- NPI number
- 1083161822
- Entity type
- Individual
- Primary specialty
- Surgical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Male
- Sole proprietor
- No
- License
- PA1645 (ME)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Practice location
818 Congress St
Portland, ME 04102-3112
Phone: (207) 773-8161
Approximate (ZIP-level) locationGet directions
Mailing address
8 Simonton St
South Portland, ME 04106-3132
Registry dates
- Enumerated
- 2016-09-09
- Last updated
- 2024-07-23
- Certified
- 2024-07-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.