Provider Demographics
NPI:1427831767
Name:CLOUTIER, TROY RICHARD (PA-C)
Entity type:Individual
Prefix:MR
First Name:TROY
Middle Name:RICHARD
Last Name:CLOUTIER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:124 ALFRED ST APT 201
Mailing Address - Street 2:
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005-2555
Mailing Address - Country:US
Mailing Address - Phone:207-831-3681
Mailing Address - Fax:
Practice Address - Street 1:300 PROFESSIONAL DR STE 2C
Practice Address - Street 2:
Practice Address - City:SCARBOROUGH
Practice Address - State:ME
Practice Address - Zip Code:04074-8897
Practice Address - Country:US
Practice Address - Phone:207-883-7926
Practice Address - Fax:207-883-1925
Is Sole Proprietor?:No
Enumeration Date:2023-08-18
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MEPA2548363A00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine