Healthcare Provider Details

I. General information

NPI: 1508917261
Provider Name (Legal Business Name): ELLIE ENKHTUYAA MUELLER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 03/05/2026
Certification Date: 03/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 MEDICAL CENTER PKWY STE 101
AUGUSTA ME
04330-8160
US

IV. Provider business mailing address

35 MEDICAL CENTER PKWY STE 101
AUGUSTA ME
04330-8160
US

V. Phone/Fax

Practice location:
  • Phone: 207-430-4321
  • Fax: 207-430-4320
Mailing address:
  • Phone: 207-430-4321
  • Fax: 207-430-4320

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD603460950
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD29451
License Number StateME
# 3
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD29451
License Number StateME
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number042-0011844
License Number StateVT
# 5
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberMD60346095
License Number StateWA
# 6
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberMD29451
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: