Individual
ELLEN MARYE PALEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2367 COLONY CROSSING PLACE, MIDLOTHIAN, VA 23112
(804) 323-1264
(804) 323-1276
Mailing address
2367 COLONY CROSSING PLACE, MIDLOTHIAN, VA 23112
(804) 323-1264
(804) 323-1276
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101102583
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10331382
—
VA
01
—
236600
ANTHEM BCBS
VA
Enumeration date
07/15/2005
Last updated
08/03/2016
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