Brubeck, Ellen Temple

Brubeck, Ellen Temple is an individual health care provider with primary practice located at 1140 N Breazeale Ave , Mount Olive NC 28365-1121. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Brubeck, Ellen Temple can be contacted via phone (919) 299-4800.

Contact Information

Primary practice address
1140 N Breazeale Ave Mount Olive NC 28365-1121
Phone: (919) 299-4800
Fax: (919) 299-4802
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 20911 North Carolina

Profile Details

NPI number 1184706830
LBN Legal business name Brubeck, Ellen Temple
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 20th, 2006
Last updated Dec 6th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184706830 NPPES
North Carolina MEDICAID 3406028
North Carolina MEDICAID 8919280
North Carolina Other 19284

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