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Individual

DR. ELLEN NMN MACE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
INTERSTATE 81 & 901 W, FCI SCHUYLKILL - HEALTH SERVICES, MINERSVILLE, PA 17954-0700
(570) 544-7100
(570) 544-7224
Mailing address
PO BOX 700, FCI SCHUYLKILL - HEALTH SERVICES, MINERSVILLE, PA 17954-0700
(570) 544-7100
(570) 544-7224

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1904
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1000582000
WV
Enumeration date
12/20/2005
Last updated
03/07/2023
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