Provider Demographics
NPI:1659445674
Name:MCQUIE, ELLEN L (MD)
Entity Type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:L
Last Name:MCQUIE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:303 N KEENE ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201-8050
Mailing Address - Country:US
Mailing Address - Phone:573-449-0808
Mailing Address - Fax:573-442-1331
Practice Address - Street 1:303 N KEENE ST
Practice Address - Street 2:SUITE 301
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-8050
Practice Address - Country:US
Practice Address - Phone:573-449-0808
Practice Address - Fax:573-442-1331
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MOMDR8F66207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
0100077OtherUNITED HEALTH CARE
106056OtherBLUE CROSS BLUE SHIELD
54595OtherGROUP HEALTH PLANS
MO202347910Medicaid
110776OtherHEALTHLINK
5158129OtherAETNA
MO003011255Medicare ID - Type Unspecified
0100077OtherUNITED HEALTH CARE