Provider Demographics
NPI:1093971053
Name:BIGELOW, ELIZABETH R (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:R
Last Name:BIGELOW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:L
Other - Last Name:D'AMORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3400 HAYDENPARK LN STE 300
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23233-7867
Mailing Address - Country:US
Mailing Address - Phone:804-998-1600
Mailing Address - Fax:804-282-0676
Practice Address - Street 1:3400 HAYDENPARK LN STE 300
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23233-7867
Practice Address - Country:US
Practice Address - Phone:804-998-1600
Practice Address - Fax:804-282-0676
Is Sole Proprietor?:No
Enumeration Date:2008-07-30
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0116018753207Q00000X
VA0101244992207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAVV3057AMedicare PIN