Mary C Ottolini, MD | |
22 Bramhall St, Portland, ME 04102-3134 | |
(207) 662-6711 | |
(207) 662-6063 |
Full Name | Mary C Ottolini |
---|---|
Gender | Female |
Speciality | Pediatrics |
Location | 22 Bramhall 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 |
---|---|---|---|
1073602884 | NPI | - | NPPES |
024354500 | Medicaid | DC | |
1822411100 | Medicaid | MD | |
6725961 | Medicaid | VA | |
0061 | Other | DC | CAREFIRST |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208M00000X | Hospitalist | MD22944 (Maine) | Secondary |
208000000X | Pediatrics | MD19738 (District Of Columbia) | Primary |
Entity Name | Childrens Hospital |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1912939703 PECOS PAC ID: 0244143170 Enrollment ID: O20031107000130 |
Mailing Address | Practice Location Address |
---|---|
Mary C Ottolini, MD 111 Michigan Ave Nw, Washington, DC 20010-2978 Ph: (202) 884-2182 | Mary C Ottolini, MD 22 Bramhall St, Portland, ME 04102-3134 Ph: (207) 662-6711 |
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 |