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NPI Code Detail

MEDICARE: ELLEN MEIERER MD

MEDICARE: ELLEN MEIERER MD
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1659020816
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELLEN MEIERER MD
Provider Business Mailing Address
First Line : 22 BRAMHALL ST
Second Line :
City : PORTLAND
State : ME
Zip : 04102-3175
Country : US
Telephone Number :
Fax Number : 207-618-5684
Provider Business Practice Location Address
First Line : 22 BRAMHALL ST
Second Line :
City : PORTLAND
State : ME
Zip : 04102-3175
Country : US
Telephone Number : 207-662-0111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2022
Last Update Date : 01/21/2026

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