Provider Demographics
NPI:1235214495
Name:NOEL, ELLA M (DO)
Entity Type:Individual
Prefix:
First Name:ELLA
Middle Name:M
Last Name:NOEL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 W BROOKE LN
Mailing Address - Street 2:P.O. BOX 146
Mailing Address - City:BLISSFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:49228-8601
Mailing Address - Country:US
Mailing Address - Phone:517-486-2411
Mailing Address - Fax:517-486-3967
Practice Address - Street 1:157 WEST BROOKE LANE
Practice Address - Street 2:
Practice Address - City:BLISSFIELD
Practice Address - State:MI
Practice Address - Zip Code:49228
Practice Address - Country:US
Practice Address - Phone:517-486-2411
Practice Address - Fax:517-486-3967
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101010222207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1154613174OtherBCBS MI
113271OtherPRIORITY HEALTH
4514719OtherAETNA
MI5183253Medicaid
102349OtherGLHP
000000525609OtherANTHEM
03615OtherPARAMOUNT
MI4711350Medicaid
5853OtherHPM
P00419399OtherRRMC
MI4711350Medicaid
MI24KP09720002Medicare PIN
$$$$$$$$$OtherTRICARE
000000525609OtherANTHEM