Provider Demographics
NPI:1194759506
Name:ROSSI, ANNE R (MD)
Entity type:Individual
Prefix:DR
First Name:ANNE
Middle Name:R
Last Name:ROSSI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:39 WALLACE AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-6143
Mailing Address - Country:US
Mailing Address - Phone:207-761-0650
Mailing Address - Fax:207-761-8198
Practice Address - Street 1:100 CAMPUS DR
Practice Address - Street 2:UNIT 107
Practice Address - City:SCARBOROUGH
Practice Address - State:ME
Practice Address - Zip Code:04074-9692
Practice Address - Country:US
Practice Address - Phone:207-885-7565
Practice Address - Fax:207-885-7577
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2014-11-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ME014642208000000X, 2080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30010360Medicaid
ME277240099Medicaid
MEMM677102Medicare PIN
MEMM6771Medicare PIN
MEMM677101Medicare PIN
NH30010360Medicaid