Provider Demographics
NPI:1780665695
Name:TOTTEN, MARY ANNE (MD)
Entity Type:Individual
Prefix:
First Name:MARY ANNE
Middle Name:
Last Name:TOTTEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 WEBSTER ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03104-2512
Mailing Address - Country:US
Mailing Address - Phone:603-663-7030
Mailing Address - Fax:603-663-7039
Practice Address - Street 1:138 WEBSTER ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03104-2512
Practice Address - Country:US
Practice Address - Phone:603-663-7030
Practice Address - Fax:603-663-7039
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1311207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH011679OtherTUFTS PIN
NH30202285Medicaid
NH380001830OtherRR MEDICARE PIN
NH01YP03909NH01OtherANTHEM ACES PIN
NH4396152OtherAETNA PIN
NHB42657OtherANTHEM REFERRING UPIN
NHB42657OtherHPHC PIN
NH0406760OtherUHC PIN
NH579606OtherCIGNA PIN
NHB42657OtherHPHC PIN
NHRE6746Medicare PIN