Organization
ELLEN J. BENTLEY, M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELLEN J BENTLEY M.D. (OWNER)
(207) 945-4300
Entity
Organization
Contact information
Practice address
700 MOUNT HOPE AVE, SUITE 430, BANGOR, ME 04401-5691
(207) 945-4300
(207) 945-0755
Mailing address
700 MOUNT HOPE AVE, SUITE 430, BANGOR, ME 04401-5691
(207) 945-4300
(207) 945-0755
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
013186
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041320
ANTHEM
ME
05
—
135340000
—
ME
01
—
2645719
AETNA IND
ME
01
—
M7321
CIGNA
ME
Enumeration date
10/27/2006
Last updated
11/06/2014
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