Provider Demographics
NPI:1215214291
Name:LE PABIC, ELANA ENGSTROM (MD)
Entity Type:Individual
Prefix:DR
First Name:ELANA
Middle Name:ENGSTROM
Last Name:LE PABIC
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ELANA
Other - Middle Name:
Other - Last Name:ENGSTROM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:715 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-7574
Mailing Address - Country:US
Mailing Address - Phone:910-763-2476
Mailing Address - Fax:910-763-8176
Practice Address - Street 1:715 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-7574
Practice Address - Country:US
Practice Address - Phone:910-763-2476
Practice Address - Fax:910-763-8176
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-04
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2017-00332208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics