Provider Demographics
NPI:1508917261
Name:MUELLER, ELLIE ENKHTUYAA (MD)
Entity type:Individual
Prefix:
First Name:ELLIE
Middle Name:ENKHTUYAA
Last Name:MUELLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 MEDICAL CENTER PKWY STE 101
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04330-8160
Mailing Address - Country:US
Mailing Address - Phone:207-430-4321
Mailing Address - Fax:207-430-4320
Practice Address - Street 1:35 MEDICAL CENTER PKWY STE 101
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-8160
Practice Address - Country:US
Practice Address - Phone:207-430-4321
Practice Address - Fax:207-430-4320
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT042-0011844207R00000X
MEMD29451207R00000X, 207RC0000X, 207RI0011X
WAMD603460950207RC0000X
WAMD60346095207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease