Basic Information
| Provider Information | |||||||||
| NPI: | 1013008382 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DEUTSCH | ||||||||
| FirstName: | ELLEN | ||||||||
| MiddleName: | S. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | NEMOURS CHILDRENS CLINIC | ||||||||
| Address2: | P.O. BOX 404112 | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303840001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9043903610 | ||||||||
| FaxNumber: | 9042885890 | ||||||||
| Practice Location | |||||||||
| Address1: | A.I. DUPONT HOSPITAL FOR CHILDREN | ||||||||
| Address2: | 1600 ROCKLAND ROAD | ||||||||
| City: | WILMINGTON | ||||||||
| State: | DE | ||||||||
| PostalCode: | 198033607 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3026515895 | ||||||||
| FaxNumber: | 3026514945 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/28/2006 | ||||||||
| LastUpdateDate: | 05/06/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207YP0228X | C10005051 | DE | Y | Allopathic & Osteopathic Physicians | Otolaryngology | Pediatric Otolaryngology |
ID Information
| ID | Type | State | Issuer | Description | 001230041 | 05 | PA | MEDICAID | 7610282 | 05 | NC | MEDICAID | P8B201196 | 05 | TX | MEDICAID | Q05051 | 05 | SC | MEDICAID | 0561407 | 05 | IA | MEDICAID | 2077381 | 05 | OH | MEDICAID | 02053547 | 05 | NY | MEDICAID | 2501414 | 05 | NJ | MEDICAID | 8011036 | 05 | MD | MEDICAID |