Individual provider · NPI-1

Dr. Justine Marie Achille, MD

Family Medicine · Gorham, ME

NPI number1962962324

StatusActive

Last updated in NPPESSep 28, 2022

Details

NPI: 1962962324
Entity type: Individual (NPI-1)
Name: Dr. Justine Marie Achille
Credential: MD
Sex: Female
Sole proprietor: No
Enumeration date: Mar 21, 2019
Certification date: Sep 28, 2022
Last updated: Sep 28, 2022

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
207Q00000X	Family Medicine	MD26128	ME	Yes
390200000X	Student in an Organized Health Care Education/Training Program	–	–

Practice location

575 Main St
Gorham, ME 04038-2623

Phone 207-839-2559

Mailing address

Po Box 9746
Portland, ME 04104-5040

Phone 207-828-2449

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