Provider Demographics
NPI:1881071850
Name:DEFEO, ELITA M (DO)
Entity type:Individual
Prefix:
First Name:ELITA
Middle Name:M
Last Name:DEFEO
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Gender:F
Credentials:DO
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Mailing Address - Street 1:35 MEDICAL CENTER PKWY
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04330-8160
Mailing Address - Country:US
Mailing Address - Phone:207-626-1360
Mailing Address - Fax:207-626-1359
Practice Address - Street 1:35 MEDICAL CENTER PKWY
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-8160
Practice Address - Country:US
Practice Address - Phone:207-626-1360
Practice Address - Fax:207-626-1359
Is Sole Proprietor?:No
Enumeration Date:2015-04-29
Last Update Date:2021-07-27
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Provider Licenses
StateLicense IDTaxonomies
MEDO3181207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease