Provider Demographics
NPI:1851394290
Name:DROEGE, ELIZABETH ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:ANN
Last Name:DROEGE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:826 N 6TH ST
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:IN
Mailing Address - Zip Code:47960-1752
Mailing Address - Country:US
Mailing Address - Phone:574-583-3333
Mailing Address - Fax:574-583-2896
Practice Address - Street 1:826 N 6TH ST
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:IN
Practice Address - Zip Code:47960-1752
Practice Address - Country:US
Practice Address - Phone:574-583-3333
Practice Address - Fax:574-583-2896
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2014-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01035035A207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200010740Medicaid
7571356OtherAETNA
000000357680OtherANTHEM BLUE CROSS
INP01121286OtherRAIL ROAD MEDICARE
INP01121286OtherRAILROAD MEDICARE
7571356OtherAETNA
IN192590001Medicare PIN