Provider Demographics
NPI:1225132384
Name:TRIMBLE, ELIZABETH SOUTH (MD, JD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:SOUTH
Last Name:TRIMBLE
Suffix:
Gender:F
Credentials:MD, JD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DEPT OF VETERANS AFFAIRS MEDICAL CTR
Mailing Address - Street 2:50 IRVING STREET NW, MAIL STOP 11C
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20422
Mailing Address - Country:US
Mailing Address - Phone:202-745-8000
Mailing Address - Fax:
Practice Address - Street 1:DEPT OF VETERANS AFFAIRS MEDICAL CTR
Practice Address - Street 2:50 IRVING STREET NW, MAIL STOP 11C
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20422
Practice Address - Country:US
Practice Address - Phone:202-745-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD035886207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCMD035886OtherMEDICAL LICENSE