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Organization

MAURICE C. HOTHEM, DO PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MC HOTHEM DO (OWNER AND PROVIDER)
(207) 797-4148
Entity
Organization

Contact information

Practice address
222 AUBURN ST, PORTLAND, ME 04103-6004
(207) 797-4148
(207) 797-5730
Mailing address
222 AUBURN ST, PORTLAND, ME 04103-6004
(207) 797-4148
(207) 797-5730

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
115730000
ME
01
M9150
CIGNA
ME
Enumeration date
12/08/2006
Last updated
06/25/2008
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