Provider Demographics
NPI:1811985963
Name:HOTELLING, DAVID RAWSON (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:RAWSON
Last Name:HOTELLING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:477 CONGRESS ST
Mailing Address - Street 2:5TH FLOOR
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04101-3427
Mailing Address - Country:US
Mailing Address - Phone:207-773-6463
Mailing Address - Fax:207-828-4587
Practice Address - Street 1:477 CONGRESS ST
Practice Address - Street 2:5TH FLOOR
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101-3427
Practice Address - Country:US
Practice Address - Phone:207-773-6463
Practice Address - Fax:207-828-4587
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-12
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ME006607207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME065366OtherPTAN
065366Medicare ID - Type Unspecified
ME065366OtherPTAN