Provider Demographics
NPI:1629124136
Name:SINCEBAUGH, ELS (PAC)
Entity Type:Individual
Prefix:MS
First Name:ELS
Middle Name:
Last Name:SINCEBAUGH
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 727
Mailing Address - Street 2:
Mailing Address - City:WATERVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04903-0727
Mailing Address - Country:US
Mailing Address - Phone:207-864-3303
Mailing Address - Fax:207-864-2969
Practice Address - Street 1:42 DALLAS HILL RD
Practice Address - Street 2:
Practice Address - City:RANGELEY
Practice Address - State:ME
Practice Address - Zip Code:04970-4032
Practice Address - Country:US
Practice Address - Phone:207-864-3303
Practice Address - Fax:207-864-2969
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00054600363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
P83820Medicare UPIN