Provider Demographics
NPI:1548286156
Name:MICHALOWSKI, ELLEN ELIZABETH (MD)
Entity type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:ELIZABETH
Last Name:MICHALOWSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:194 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FORT KENT
Mailing Address - State:ME
Mailing Address - Zip Code:04743-1428
Mailing Address - Country:US
Mailing Address - Phone:207-834-1161
Mailing Address - Fax:207-834-3285
Practice Address - Street 1:142 W MAIN ST
Practice Address - Street 2:
Practice Address - City:FORT KENT
Practice Address - State:ME
Practice Address - Zip Code:04743-1230
Practice Address - Country:US
Practice Address - Phone:207-834-1161
Practice Address - Fax:207-834-3285
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ME014320207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E28386Medicare UPIN