Provider Demographics
NPI:1659785194
Name:HADJICHARALAMBOUS, ELENA MARGARITE (MD)
Entity Type:Individual
Prefix:DR
First Name:ELENA
Middle Name:MARGARITE
Last Name:HADJICHARALAMBOUS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1548 E 4500 S
Mailing Address - Street 2:STE 202
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84117
Mailing Address - Country:US
Mailing Address - Phone:801-266-8841
Mailing Address - Fax:801-266-0449
Practice Address - Street 1:1548 E 4500 S
Practice Address - Street 2:STE 202
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84117
Practice Address - Country:US
Practice Address - Phone:801-266-8841
Practice Address - Fax:801-266-0449
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-12
Last Update Date:2019-03-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT10677587-1205207NS0135X, 207N00000X
MI4301105645207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology