Provider Demographics
NPI:1366454787
Name:TRASK, ELIZABETH JETER (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:JETER
Last Name:TRASK
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 1:76 PEACHTREE RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-3131
Mailing Address - Country:US
Mailing Address - Phone:828-254-1969
Mailing Address - Fax:828-254-4611
Practice Address - Street 1:76 PEACHTREE RD
Practice Address - Street 2:SUITE 300
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-3131
Practice Address - Country:US
Practice Address - Phone:828-254-1969
Practice Address - Fax:828-254-4611
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC28990207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8983697Medicaid
NC211031AMedicare ID - Type Unspecified
NC8983697Medicaid