Provider Demographics
NPI:1083782916
Name:ROTHE, ELIZABETH E (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:E
Last Name:ROTHE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:77 BATES ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-7637
Mailing Address - Country:US
Mailing Address - Phone:207-795-8465
Mailing Address - Fax:207-795-8471
Practice Address - Street 1:77 BATES ST
Practice Address - Street 2:SUITE 201
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-7637
Practice Address - Country:US
Practice Address - Phone:207-795-8465
Practice Address - Fax:207-795-8471
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2010-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ME017769207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME433309399Medicaid
ME000890902Medicare PIN