Provider Demographics
NPI:1568298149
Name:RHYDER, MADISON CAMILLE (PA-C)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:CAMILLE
Last Name:RHYDER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:885 UNION ST STE 145
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-3073
Mailing Address - Country:US
Mailing Address - Phone:207-973-9595
Mailing Address - Fax:
Practice Address - Street 1:885 UNION ST STE 145
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-3073
Practice Address - Country:US
Practice Address - Phone:207-973-9595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-11
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant