Provider Demographics
NPI:1417985508
Name:BOLLENBACHER, ELIZABETH (DO)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:BOLLENBACHER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:417 STATE ST
Mailing Address - Street 2:STE 400
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-6630
Mailing Address - Country:US
Mailing Address - Phone:207-942-6096
Mailing Address - Fax:207-973-8857
Practice Address - Street 1:417 STATE ST
Practice Address - Street 2:STE 400
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-6630
Practice Address - Country:US
Practice Address - Phone:207-942-6096
Practice Address - Fax:207-973-8857
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2014-11-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ME1944207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease