Dr Colby A Wyatt, MD PHD | |
887 Congress St, Suite 320, Portland, ME 04102 | |
(207) 662-5522 | |
(207) 662-5527 |
Full Name | Dr Colby A Wyatt |
---|---|
Gender | Male |
Speciality | Pediatrics - Pediatric Pulmonology |
Location | 887 Congress St, Portland, Maine |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1073788956 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2080P0214X | Pediatrics - Pediatric Pulmonology | MD19591 (Maine) | Primary |
208000000X | Pediatrics | MD19591 (Maine) | Secondary |
Entity Name | Maine Medical Partners |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1134144090 PECOS PAC ID: 9335043967 Enrollment ID: O20040331000191 |
Entity Name | Mainehealth |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1790265502 PECOS PAC ID: 7517860588 Enrollment ID: O20040701000166 |
Entity Name | Maine Medical Partners |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1992719272 PECOS PAC ID: 9335043967 Enrollment ID: O20050901000035 |
Mailing Address | Practice Location Address |
---|---|
Dr Colby A Wyatt, MD PHD 301c Us Route One, Scarborough, ME 04074 Ph: (207) 396-8600 | Dr Colby A Wyatt, MD PHD 887 Congress St, Suite 320, Portland, ME 04102 Ph: (207) 662-5522 |
Rushika M Conroy, M.D. Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 41 Donald B Dean Dr Ste A, Portland, ME 04106 Phone: 207-661-6064 | |
Michael Alexander Ferguson, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 22 Bramhall St, Mmc Picu, Portland, ME 04102 Phone: 207-662-6711 | |
Dr. Rute S Rothwell, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 22 Bramhall St, Portland, ME 04102 Phone: 207-662-7060 | |
Kenneth Lombard, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 887 Congress St, Suite 410b, Portland, ME 04102 Phone: 207-662-5522 Fax: 207-662-5526 | |
David F Cox, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 22 Bramhall St, Portland, ME 04102 Phone: 207-662-2353 | |
Marie H Tanzer, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 887 Congress St, Suite 320, Portland, ME 04102 Phone: 207-662-5522 Fax: 207-662-5527 | |
Daniel Sobel, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 22 Bramhall St, Portland, ME 04102 Phone: 800-482-1415 Fax: 800-482-1415 |