Healthcare Provider Details

I. General information

NPI: 1770043036
Provider Name (Legal Business Name): PASQUALE MAROTTA DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2019
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

96 CAMPUS DR
SCARBOROUGH ME
04074-7163
US

IV. Provider business mailing address

96 CAMPUS DR
SCARBOROUGH ME
04074-7163
US

V. Phone/Fax

Practice location:
  • Phone: 207-885-9905
  • Fax: 207-396-5600
Mailing address:
  • Phone: 207-885-9905
  • Fax: 207-396-5600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberDO4367
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: