Provider Demographics
NPI:1639302151
Name:NADER, ELIE TONY (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIE
Middle Name:TONY
Last Name:NADER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:98 15TH ST NW
Mailing Address - Street 2:STE 201A
Mailing Address - City:NORTON
Mailing Address - State:VA
Mailing Address - Zip Code:24273-1600
Mailing Address - Country:US
Mailing Address - Phone:276-439-1490
Mailing Address - Fax:276-439-1495
Practice Address - Street 1:98 15TH ST NW
Practice Address - Street 2:STE 201A
Practice Address - City:NORTON
Practice Address - State:VA
Practice Address - Zip Code:24273-1600
Practice Address - Country:US
Practice Address - Phone:276-439-1490
Practice Address - Fax:276-439-1495
Is Sole Proprietor?:No
Enumeration Date:2009-09-01
Last Update Date:2017-02-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101260062207R00000X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1639302151Medicaid
VA1639302151Medicaid