Provider Demographics
NPI:1033679774
Name:MCELROY, MOLLY WHITTAKER (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:MOLLY
Middle Name:WHITTAKER
Last Name:MCELROY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 BLUE RIDGE RD STE 300
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-8002
Mailing Address - Country:US
Mailing Address - Phone:919-781-7500
Mailing Address - Fax:919-645-3054
Practice Address - Street 1:3100 BLUE RIDGE RD STE 300
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-8002
Practice Address - Country:US
Practice Address - Phone:919-781-7500
Practice Address - Fax:919-645-3054
Is Sole Proprietor?:No
Enumeration Date:2019-03-20
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-08519207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology