Provider Demographics
NPI:1992230726
Name:DEPOY, ELLEN MICHELLE (MD)
Entity type:Individual
Prefix:
First Name:ELLEN
Middle Name:MICHELLE
Last Name:DEPOY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ELLEN
Other - Middle Name:MICHELLE
Other - Last Name:GIBSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:G
Mailing Address - Street 1:2150 HARRISBURG PIKE
Mailing Address - Street 2:SUITE 220A
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601
Mailing Address - Country:US
Mailing Address - Phone:717-396-9167
Mailing Address - Fax:
Practice Address - Street 1:2150 HARRISBURG PIKE
Practice Address - Street 2:SUITE 220A
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601
Practice Address - Country:US
Practice Address - Phone:717-396-9167
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-30
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4747682084N0400X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology