Provider Demographics
NPI:1992125785
Name:DEERAN, ELISABETH W (MD)
Entity type:Individual
Prefix:
First Name:ELISABETH
Middle Name:W
Last Name:DEERAN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:100 GANNETT DRIVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-5900
Mailing Address - Country:US
Mailing Address - Phone:207-828-0361
Mailing Address - Fax:207-874-1483
Practice Address - Street 1:84 MARGINAL WAY
Practice Address - Street 2:SUITE 900
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101
Practice Address - Country:US
Practice Address - Phone:207-874-2445
Practice Address - Fax:207-523-8598
Is Sole Proprietor?:No
Enumeration Date:2014-04-21
Last Update Date:2025-01-14
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Provider Licenses
StateLicense IDTaxonomies
MEMD23051207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology