Ellen Michelle Provost DO

NPI 1053344572 - Internal Medicine - 207R00000X

NPI Details
NPI 1053344572
Gender Female
Enumeration Date 07/08/2006
Last Updated 10/17/2008
Entity Type Individual
Active Over 10 years ago
Practice Location
4315 DIPLOMACY DR
ANCHORAGE AK, 99508-5926, US
Phone (907) 729-1500
Fax (907) 729-2082
Business Location
4315 DIPLOMACY DR
ANCHORAGE AK, 99508-5926, US
Phone (907) 729-1500
Fax (907) 729-2082
Toxanomy
Taxonomy Code 207R00000X
License State Alaska
License Number 2717
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According to our database, Ellen Michelle Provost DO NPI is 1053344572, taxonomy code is 207R00000X and license number is 2717, license state is located at Alaska. Ellen Michelle Provost DO physically located at 4315 Diplomacy Dr, Anchorage AK, 99508-5926. NPI Number Ellen Michelle Provost DO has the Individual type.

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1053344572 NPI number is provided on an as is basis without warranty of any kind. 1053344572 is maintained by the National Plan & Provider Enumeration System. The contents of Ellen Michelle Provost DO are for informational purposes only.