Healthcare Provider Details

I. General information

NPI: 1598794505
Provider Name (Legal Business Name): THERESA PIOTROWSKI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 01/10/2022
Certification Date: 01/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 MILES ST
DAMARISCOTTA ME
04543-4047
US

IV. Provider business mailing address

18 ARBOR WAY
GROTON MA
01450-1155
US

V. Phone/Fax

Practice location:
  • Phone: 207-661-2018
  • Fax:
Mailing address:
  • Phone: 610-849-6508
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QB0002X
TaxonomyObesity Medicine (Family Medicine) Physician
License NumberMD24136
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code207QB0002X
TaxonomyObesity Medicine (Family Medicine) Physician
License Number75112
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD24139
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: