Provider Demographics
NPI:1548239676
Name:ELLIOTT, ESTHER ELIZABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:ESTHER
Middle Name:ELIZABETH
Last Name:ELLIOTT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2142
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-8942
Mailing Address - Country:US
Mailing Address - Phone:410-822-6175
Mailing Address - Fax:410-604-7349
Practice Address - Street 1:508 IDLEWILD AVE
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-3834
Practice Address - Country:US
Practice Address - Phone:410-822-9133
Practice Address - Fax:410-822-9513
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2018-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD59939207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD401998900Medicaid
H86481Medicare UPIN
MD401998900Medicaid