DR. OTONIEL DAVID PUERTO (NPI# 1568459667) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568459667 |
| Entity Type | Individual |
| Full Name | DR. OTONIEL DAVID PUERTO |
| Credential | MD |
| Practice Address |
360 Broadway Bangor ME 04401 |
| Mailing Address |
C/o St Marys Health System - Provider Enrollment Po Box 7291 Lewiston ME 04243-7291 |
| Practice Telephone | 2079071430 |
| Practice Fax Number | 2079073508 |
| Mailing Telephone | 2077778941 |
| Mailing Fax Number | 2077778800 |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2019-11-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207L00000X | Anesthesiology | MD22859 | ME | Allopathic & Osteopathic Physicians |
| N | 207L00000X | Anesthesiology | 34465 | KY | Allopathic & Osteopathic Physicians |
| N | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
34465 | KY | Allopathic & Osteopathic Physicians |
| Street Address |
360 BROADWAY |
| City | BANGOR |
| State | ME |
| Zip Code | 04401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154321545 | St. Joseph Hospital | General Acute Care Hospital | 360 Broadway, Bangor, ME 04401-3979 | 2005-07-28 |
| 1346802170 | Sadie Austin | Physician Assistant | 360 Broadway, Bangor, ME 04401-3900 | 2019-07-02 |
| 1386202794 | Ashley Gott Haase | Physical Therapist | 360 Broadway, Bangor, ME 04401-3979 | 2019-05-31 |
| 1992286546 | Royce Blackwood | Physician Assistant | 360 Broadway, Bangor, ME 04401-3979 | 2018-08-22 |
| 1609356559 | Casey Marie Northup | Pharmacy Technician | 360 Broadway, Bangor, ME 04401-3900 | 2018-08-20 |
| 1407332869 | Sara Winings | Pharmacist | 360 Broadway, Bangor, ME 04401-3979 | 2018-07-18 |
| 1811489156 | Sandra Bartlett | Pharmacist | 360 Broadway, Bangor, ME 04401-3979 | 2018-06-02 |
| 1366999534 | Eliza Sharma | Internal Medicine | 360 Broadway, Bangor, ME 04401-3900 | 2016-09-06 |
| 1871946731 | Katelyn Hopper | Anesthesiology | 360 Broadway, Bangor, ME 04401-3979 | 2016-07-15 |
| 1790139459 | Stephen Calabrese | Anesthesiology | 360 Broadway, Bangor, ME 04401-3979 | 2016-04-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184222523 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 110 Longview Dr, Bangor, ME 04401 | 2020-10-16 |
| 1033737937 | Daniel John Phulman | Counselor | 202 Exchange Street, Bangor, ME 04401 | 2020-07-08 |
| 1770104358 | Elizabeth Sarah Caruson | Physician Assistant | 417 State Street Webber Medical Building, East St, Ste. 121, Bangor, ME 04401 | 2020-05-05 |
| 1053961300 | Erika Dean | Occupational Therapist | 84 Sylvan Rd., Bangor, ME 04401 | 2019-09-18 |
| 1942853635 | Wildworks Therapy, Pllc | Occupational Therapist | 123 Mt Hope Ave, Bangor, ME 04401 | 2019-07-22 |
| 1255999173 | Jessica Arbisi | Physician Assistant | 1 Northeast Drive, Bangor, ME 04401 | 2019-06-05 |
| 1699232041 | Ehab Khamis Elhefnawi | Anesthesiology | Emmc Anesthesia Professional Service, 489 State Street, Bangor, ME 04401 | 2019-02-21 |
| 1477028884 | Zvorufura Makura | Otolaryngology | 885 Union Street, Ste 145, Bangor, ME 04401 | 2018-10-11 |
| 1255826541 | Lindsey M Fields | Optometrist | 955 Broadway Eye Center Northeast Dba Northeast Eyecare, Bangor, ME 04401 | 2018-06-28 |
| 1992211338 | Debra J Mcintyre | Counselor | 157 Park Street, #5, Bangor, ME 04401 | 2017-12-21 |
| Find all providers in zip 04401 | ||||
| Taxonomy Code | 207L00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699232041 | Ehab Khamis Elhefnawi | Anesthesiology | Emmc Anesthesia Professional Service, 489 State Street, Bangor, ME 04401 | 2019-02-21 |
| 1508113788 | Amanda Yap | Anesthesiology | Eastern Maine Medical Center, 489 State Street, Bangor, ME 04401 | 2012-08-07 |
| 1417263302 | Mohamed Gaber | Anesthesiology | 489 State St # P-3, Bangor, ME 04401-6616 | 2010-08-30 |
| 1972731792 | Sandeep Narayan | Anesthesiology | 489 State Street Eastern Maine Medical Center, Anesthesia Professional Services, Bangor, ME 04401-4206 | 2009-07-01 |
| 1518093905 | Shubha Vanessa Yvonne Raju | Anesthesiology | 925 Union St Ste 2, Bangor, ME 04401-3051 | 2007-02-27 |
| 1639181423 | Gerald Berlin | Anesthesiology | 404 State St Ste 200, Bangor, ME 04401-6652 | 2006-08-12 |
| 1871946731 | Katelyn Hopper | Anesthesiology | 360 Broadway, Bangor, ME 04401-3979 | 2016-07-15 |
| 1790139459 | Stephen Calabrese | Anesthesiology | 360 Broadway, Bangor, ME 04401-3979 | 2016-04-19 |
| 1558757989 | Jacob Mintzer | Anesthesiology | 489 State St, Bangor, ME 04401-6616 | 2015-04-13 |
| 1003213208 | Spectrum Medical Group, P.a. | Anesthesiology | 489 State St, Bangor, ME 04401-6616 | 2014-12-03 |
| Find all providers in BANGOR | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.