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General NPI Number Information
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NPI Number | 1225253792
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Entity Type | Individual
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Provider Name | CHARLES THOMAS MOLTA MD
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Gender | Male
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 01/29/2025
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Provider Practice Location Address
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Address Line | 685 SABATTUS ST
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City | LEWISTON
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State | ME
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Zip | 04240-3831
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Country | US
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Telephone | 207-784-1699
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Fax | 207-784-7554
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Provider Business Mailing Address
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Address Line | 685 SABATTUS ST
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City | LEWISTON
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State | ME
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Zip | 04240-3831
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Country | US
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Telephone | 207-784-1699
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Fax | 207-784-7554
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | MD433419
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | MD28543
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License Number State | ME
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Taxonomy #3
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 35053258
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License Number State | OH
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