| Christine L Petersen, MD | |
|
22 Bramhall St, Portland, ME 04102-3134 | |
| (207) 662-4735 | |
| Not Available |
| Full Name | Christine L Petersen |
|---|---|
| Gender | Female |
| Speciality | Radiology - Diagnostic Radiology |
| 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 |
|---|---|---|---|
| 1578554044 | NPI | - | NPPES |
| 1578554044 | Medicaid | ME | |
| 2061350 | Other | MASSMEDICAID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 220273 (Massachusetts) | Primary |
| 2085R0202X | Radiology - Diagnostic Radiology | MD25614 (Maine) | Secondary |
| Entity Name | Umass Memorial Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1760445373 PECOS PAC ID: 4284539891 Enrollment ID: O20040113000267 |
| Entity Name | Umass Memorial Radiology Phys Serv |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1639122096 PECOS PAC ID: 6800868779 Enrollment ID: O20040811000206 |
| Mailing Address | Practice Location Address |
|---|---|
| Christine L Petersen, MD Po Box 415348, Boston, MA 02241-5348 Ph: (800) 225-8885 | Christine L Petersen, MD 22 Bramhall St, Portland, ME 04102-3134 Ph: (207) 662-4735 |
Michael O'malley Quinn, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 22 Bramhall St, Portland, ME 04102 Phone: 207-662-2571 |
Sarah Virginia Brockett, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 22 Bramhall St, Portland, ME 04102 Phone: 207-662-0111 |
Elena Leah Resnick, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 22 Bramhall St, Portland, ME 04102 Phone: 207-662-2571 |
Matthew D Ralston, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 22 Bramhall St, Portland, ME 04102 Phone: 207-662-2571 |
Jerald Christopher Kuhn, M.D. Radiology Medicare: May Accept Medicare Assignments Practice Location: 144 State St, Portland, ME 04101 Phone: 207-879-3000 |
Whitney H Beeler, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 22 Bramhall St, Portland, ME 04102 Phone: 207-662-4735 Fax: 207-662-6388 |
David Russell Langdon, M.D. Radiology Medicare: May Accept Medicare Assignments Practice Location: 144 State St, Portland, ME 04101 Phone: 207-879-3000 |