Provider Demographics
NPI:1740385012
Name:TREFTS, C ELIZABETH (MD)
Entity Type:Individual
Prefix:
First Name:C
Middle Name:ELIZABETH
Last Name:TREFTS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CORA
Other - Middle Name:ELIZABETH
Other - Last Name:TREFTS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:489 STATE ST
Mailing Address - Street 2:GREYSTONE BLDG.
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-6616
Mailing Address - Country:US
Mailing Address - Phone:207-973-8955
Mailing Address - Fax:207-973-9509
Practice Address - Street 1:489 STATE ST
Practice Address - Street 2:GREYSTONE BLDG.
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-6616
Practice Address - Country:US
Practice Address - Phone:207-973-8955
Practice Address - Fax:207-973-9509
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2020-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME013357208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics