MEDICARE: ELLEN LOUISE MAFFEO PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2471C3402X	Radiography Radiologic Technologist
2	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1639950173
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELLEN LOUISE MAFFEO PA-C

Provider Business Mailing Address
First Line	:	4688 SAVAGE HILLS DR
Second Line	:
City	:	MACON
State	:	GA
Zip	:	31210-2324
Country	:	US
Telephone Number	:	478-718-1844
Fax Number	:

Provider Business Practice Location Address
First Line	:	4688 SAVAGE HILLS DR
Second Line	:
City	:	MACON
State	:	GA
Zip	:	31210-2324
Country	:	US
Telephone Number	:	478-718-1844
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/11/2023
Last Update Date	:	10/11/2023

Similar Medicare Providers

1366855132 — SUSAN BROCK L.M.T.
Practice Location Address:

3260 VINEVILLE AVE
MACON, GA
31204-2324

Practice Phone: 478-960-6366
Practice Fax:

1922019355 — JASON EDWARD WILDER R, MR
Practice Location Address:

1504 HARDEMAN AVE , SUITE B
MACON, GA
31201-1416

Practice Phone: 478-745-3135
Practice Fax: 478-745-3136

1760948780 — MRS. HOLLY CELLAMARE PA-C, RT (R)
Practice Location Address:

745 MEADOWS RD STE 200
BOCA RATON, FL
33486-2324

Practice Phone: 561-955-6784
Practice Fax: 833-625-1611

1568473957 — CHRISTOPHER SHANNON HARRIS R, MR
Practice Location Address:

1504 HARDEMAN AVE , SUITE B
MACON, GA
31201-1416

Practice Phone: 478-745-3135
Practice Fax:

1801807201 — DEBORAH ANN KOVALICK-LEGGETT R
Practice Location Address:

1504 HARDEMAN AVE , SUITE B
MACON, GA
31201-1416

Practice Phone: 478-745-3135
Practice Fax: 478-745-3136

1891706214 — DUANE ENNIS R, CT
Practice Location Address:

1504 HARDEMAN AVE , SUITE B
MACON, GA
31201-1416

Practice Phone: 478-745-3135
Practice Fax: 478-745-3136

Directions to “ ELLEN LOUISE MAFFEO PA-C” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.