Susan G Ostertag, MD

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

License

013665 Issued in ME

Practice address

992 Union St
Penobscot Community Health Center
Bangor, ME 04401-3057

Phone

(207) 945-5247

NPI assigned

Jun 14, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393804800000",
    "number": "1902849979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1599",
            "address_2": "PENOBSCOT COMMUNITY HEALTH CENTER",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044021599",
            "telephone_number": "207-945-5247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "992 UNION ST",
            "address_2": "PENOBSCOT COMMUNITY HEALTH CENTER",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013057",
            "telephone_number": "207-945-5247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSTERTAG",
        "first_name": "SUSAN",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-14",
        "last_updated": "2014-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "ME",
            "license": "013665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter Osberg, LCPC-C
• Jeffrey A Osborne, FNP, PMHNP
• Pius Amoateng Osei-Bagyina, MD, MPH
• Kevin A Osgood, MD
• Chad Osmars, PHARMD
• Sheryl Lyn Ostrow, LCSW
• Justin Otis, MD
• Wade Joel Otruba, M.D.
• Autumn Lee Otto, PA-C
• Cory Ouellette, DPT

• Geriatric Medicine (Family Medicine) Physician in Bangor, ME
• Providers in Bangor, ME by specialty
• Geriatric Medicine (Family Medicine) Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.