Provider Demographics
NPI:1477641801
Name:GRATTAN, ELIZABETH GAMBRELL (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:GAMBRELL
Last Name:GRATTAN
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Gender:F
Credentials:MD
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Mailing Address - Street 1:15830 BALLANTYNE MEDICAL PL
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-4653
Mailing Address - Country:US
Mailing Address - Phone:704-341-0090
Mailing Address - Fax:704-341-0092
Practice Address - Street 1:15830 BALLANTYNE MEDICAL PL
Practice Address - Street 2:SUITE 100
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-4653
Practice Address - Country:US
Practice Address - Phone:704-341-0090
Practice Address - Fax:704-341-0092
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2015-01-20
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Provider Licenses
StateLicense IDTaxonomies
SC26035207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology