Provider Demographics
NPI:1215598230
Name:ELITE GYNECOLOGY
Entity Type:Organization
Organization Name:ELITE GYNECOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:B
Authorized Official - Last Name:GEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:803-638-3946
Mailing Address - Street 1:163 LAKE MURRAY TER
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-9103
Mailing Address - Country:US
Mailing Address - Phone:803-378-6098
Mailing Address - Fax:
Practice Address - Street 1:163 LAKE MURRAY TER
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-9103
Practice Address - Country:US
Practice Address - Phone:803-378-6098
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-21
Last Update Date:2019-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty