Provider Demographics
NPI:1699974311
Name:MCATEER, CARLY (MD)
Entity type:Individual
Prefix:
First Name:CARLY
Middle Name:
Last Name:MCATEER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:272 CONGRESS ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04101-3637
Mailing Address - Country:US
Mailing Address - Phone:207-874-2466
Mailing Address - Fax:207-774-4625
Practice Address - Street 1:301C US ROUTE 1
Practice Address - Street 2:
Practice Address - City:SCARBOROUGH
Practice Address - State:ME
Practice Address - Zip Code:04074-9701
Practice Address - Country:US
Practice Address - Phone:207-396-8600
Practice Address - Fax:207-396-8632
Is Sole Proprietor?:No
Enumeration Date:2007-07-12
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD18534207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1699974311Medicaid
ME001778004Medicare PIN
ME001778006Medicare PIN
ME1699974311Medicaid
ME001778001Medicare PIN
ME001778003Medicare PIN