Provider Demographics
NPI:1205367844
Name:CARELUS, ELAINE ROSE (MD)
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:ROSE
Last Name:CARELUS
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 1:4200 NORTHSIDE PKWY NW
Mailing Address - Street 2:BUILDING 8, STE 200
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30327
Mailing Address - Country:US
Mailing Address - Phone:404-881-8020
Mailing Address - Fax:877-787-7051
Practice Address - Street 1:4200 NORTHSIDE PKWY NW
Practice Address - Street 2:BUILDING 8, SUITE 200
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327
Practice Address - Country:US
Practice Address - Phone:404-881-8020
Practice Address - Fax:877-787-7051
Is Sole Proprietor?:No
Enumeration Date:2017-03-24
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
GA92383208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program