Provider Demographics
NPI:1134117757
Name:MCELWAIN, MARIANN C (MD)
Entity Type:Individual
Prefix:
First Name:MARIANN
Middle Name:C
Last Name:MCELWAIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 NORTHPOINTE CIR
Mailing Address - Street 2:
Mailing Address - City:SEVEN FIELDS
Mailing Address - State:PA
Mailing Address - Zip Code:16046-7862
Mailing Address - Country:US
Mailing Address - Phone:724-772-1090
Mailing Address - Fax:724-772-1092
Practice Address - Street 1:300 NORTHPOINTE CIR
Practice Address - Street 2:
Practice Address - City:SEVEN FIELDS
Practice Address - State:PA
Practice Address - Zip Code:16046-7862
Practice Address - Country:US
Practice Address - Phone:724-772-1090
Practice Address - Fax:724-772-1092
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD 057799L207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01726449Medicaid
G66045Medicare UPIN
007388Medicare ID - Type Unspecified