Provider Demographics
NPI:1083622328
Name:WHITE, ELLEN W (MD)
Entity Type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:W
Last Name:WHITE
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:489 STATE ST
Mailing Address - Street 2:EMERGENCY DEPARTMENT
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-6616
Mailing Address - Country:US
Mailing Address - Phone:207-973-7250
Mailing Address - Fax:207-973-5656
Practice Address - Street 1:489 STATE ST
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-6616
Practice Address - Country:US
Practice Address - Phone:207-973-7250
Practice Address - Fax:207-973-5656
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ME017140207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine