Provider Demographics
NPI:1932829561
Name:LUCAS, COLIN
Entity type:Individual
Prefix:
First Name:COLIN
Middle Name:
Last Name:LUCAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:COLIN
Other - Middle Name:
Other - Last Name:LUCAS-MAGUIRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5 CENTRAL MAINE XING
Mailing Address - Street 2:
Mailing Address - City:GARDINER
Mailing Address - State:ME
Mailing Address - Zip Code:04345-6320
Mailing Address - Country:US
Mailing Address - Phone:207-582-6608
Mailing Address - Fax:207-582-2258
Practice Address - Street 1:5 CENTRAL MAINE XING
Practice Address - Street 2:
Practice Address - City:GARDINER
Practice Address - State:ME
Practice Address - Zip Code:04345-6320
Practice Address - Country:US
Practice Address - Phone:207-582-6608
Practice Address - Fax:207-582-2258
Is Sole Proprietor?:No
Enumeration Date:2022-09-01
Last Update Date:2025-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPA2553363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant