Individual
ELLEN M DEIBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1695 ROOSEVELT AVE STE B, YORK, PA 17408-8521
(717) 851-5503
(717) 798-3510
Mailing address
3421 CONCORD RD, YORK, PA 17402-9001
(717) 851-5503
(717) 851-5507
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
MD449870
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102862232
—
PA
05
—
2019663
—
MA
01
—
2984321
HIGHMARK BLUE SHIELD
PA
Enumeration date
04/27/2006
Last updated
04/16/2019
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