Individual
DR. STACEY ANNE ROTTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
887 CONGRESS ST, PORTLAND, ME 04102-3100
(207) 774-6368
Mailing address
887 CONGRESS ST, PORTLAND, ME 04102-3100
(207) 774-6368
Taxonomy
Speciality
Code
Description
License number
State
2086S0102X
Surgical Critical Care Physician
A156409
CA
2086S0102X
Surgical Critical Care Physician
Primary
MD23505
ME
Other
Enumeration date
06/10/2012
Last updated
03/23/2020
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