Provider Demographics
NPI:1215016878
Name:ELIA, GIOVANNI (MD)
Entity Type:Individual
Prefix:
First Name:GIOVANNI
Middle Name:
Last Name:ELIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2013 JEFFERSON ST SW FL 2
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24014-2419
Mailing Address - Country:US
Mailing Address - Phone:540-982-0237
Mailing Address - Fax:409-822-7195
Practice Address - Street 1:2013 JEFFERSON ST SW FL 2
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24014-2419
Practice Address - Country:US
Practice Address - Phone:540-982-0237
Practice Address - Fax:540-982-2719
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA49978207V00000X
VA0101233436207VH0002X, 207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VH0002XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF72433Medicare UPIN