Theodore J Pettengill, PA is a
Physician Assistant based in Sherman, Maine. Theodore J Pettengill is licensed to practice in Maine (license number PA48) and his current practice location is
226 Main Street, Sherman, Maine. He can be reached at his office (for appointments etc.) via phone at
(207) 365-4335.
NPI number for Theodore J Pettengill is 1033187596 and his current mailing address is 226 Main Street, Sherman, Maine. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1033187596.
Provider's Profile
| Full Name | Theodore J Pettengill |
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| Gender | Male |
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| Speciality | Physician Assistant |
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| Location | 226 Main Street, Sherman, Maine |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1033187596
- Provider Enumeration Date: 03/10/2006
- Last Update Date: 05/21/2013
Medical Identifiers
Medical identifiers for Theodore J Pettengill such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1033187596 | NPI | - | NPPES |
| 250940099 | Medicaid | ME | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363A00000X | Physician Assistant | PA048 (Maine) | Secondary |
| 363A00000X | Physician Assistant | PA48 (Maine) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Theodore J Pettengill is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Theodore J Pettengill, PA
226 Main Street,
Sherman, ME 04776-0000
Ph: (207) 365-4335 | Theodore J Pettengill, PA
226 Main Street,
Sherman, ME 04776-0000
Ph: (207) 365-4335 |
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