| 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 |
|---|---|
| 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 | |
Gretchen A. Pianka, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 180 Park Ave Ste 1, Portland, ME 04102 Phone: 207-874-2141 Fax: 207-874-2164 | |
Webb E. Long, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 180 Park Ave Ste 1, Portland, ME 04102 Phone: 207-874-2141 Fax: 207-874-2164 | |
David F Cox, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 22 Bramhall St, Portland, ME 04102 Phone: 207-662-2353 |