Provider Demographics
NPI:1144225277
Name:ELWARD, KURTIS SCOTT (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:KURTIS
Middle Name:SCOTT
Last Name:ELWARD
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 79777
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21279-0777
Mailing Address - Country:US
Mailing Address - Phone:434-654-7994
Mailing Address - Fax:833-732-3632
Practice Address - Street 1:540 BELVEDERE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-3215
Practice Address - Country:US
Practice Address - Phone:434-654-2830
Practice Address - Fax:833-232-3632
Is Sole Proprietor?:No
Enumeration Date:2005-06-15
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101038287207Q00000X, 207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA45139OtherOPTIMA HEALTHCARE
VA142737OtherSOUTHERN HEALTH/COVENTRY
VA7428434003OtherCIGNA HEALTHCARE
VA099085-0OtherANTHEM BLUE CROSS BLUE SH
E62963Medicare UPIN