Individual
ELIZABETH K ACKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1685 CONGRESS STREET, PORTLAND, ME 04102
(207) 774-5816
(207) 774-3329
Mailing address
100 FODEN ROAD EAST, SUITE 201, SOUTH PORTLAND, ME 04106
(207) 828-0361
(207) 874-1483
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
012073
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010559
ANTHEM
—
01
—
1040729
AETNA
—
Enumeration date
07/26/2006
Last updated
07/08/2007
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