- Practice location
- 1600 Congress St Ste B, Portland, ME 04102-2148
- Phone
- 207-774-5222
- Fax
- —
- Last updated
- September 12, 2022
Lola Louise Amdahl is a Physician Assistant based in Portland, ME. Lola Louise Amdahl practices in Portland, ME and has the professional credentials of PA-C. The NPI Number for Lola Louise Amdahl is 1487291050 and holds a License No. 055-0031471 (VT). The current practice location address for Lola Louise Amdahl is 1600 Congress St Ste B, Portland, ME 04102-2148 and can be reached out via phone at 207-774-5222.
Provider Profile Details
- NPI Number
- 1487291050
- Provider Name
- Lola Louise Amdahl
- Credential
- PA-C
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 1600 Congress St Ste B, Portland, ME 04102-2148
- Phone Number
- 207-774-5222
- Primary Taxonomy
- Physician Assistant · 363A00000X
- Sole Proprietor
- No
- Provider Enumeration Date
- December 3, 2019
- Last Update Date
- September 12, 2022
- Certification Date
- September 12, 2022
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 1600 Congress St Ste B
Portland, ME 04102-2148 - City
- Portland
- State
- Maine
- Zip
- 04102-2148
- Phone Number
- 207-774-5222
Provider Business Mailing Address Details
- Address
- 557 Ocean St
South Portland, ME 04106-6625 - City
- South Portland
- State
- ME
- Zip
- 04106-6625
- Phone Number
- 603-252-0556
License Information
- License Number (1)
- 055-0031471
- License State (1)
- VT
- Taxonomy (1)
- Physician Assistant · 363A00000X
- Taxonomy (2)
- Student in an Organized Health Care Education/Training Program · 390200000X
- License Number (3)
- PA2334
- License State (3)
- ME
- Taxonomy (3)
- Physician Assistant · 363A00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Lola L Amdahl, PA-C?
The NPI number of Lola L Amdahl, PA-C is 1487291050. It was assigned on December 3, 2019 and is currently active in the NPPES registry.
What is the specialty of Lola L Amdahl, PA-C?
Lola L Amdahl, PA-C is registered under the primary taxonomy Physician Assistant (code 363A00000X), licensed in VT under license number 055-0031471.
Where does Lola L Amdahl, PA-C practice?
The practice location is 1600 Congress St Ste B, Portland, ME 04102-2148. The office can be reached at 207-774-5222 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1487291050 directly on the NPPES registry website.