Provider Demographics
NPI:1710942016
Name:ELSTON, SCOTT C (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:C
Last Name:ELSTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1234 HUFFMAN MILL ROAD
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-8700
Mailing Address - Country:US
Mailing Address - Phone:336-538-1234
Mailing Address - Fax:336-584-6811
Practice Address - Street 1:1234 HUFFMAN MILL ROAD
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-8700
Practice Address - Country:US
Practice Address - Phone:336-538-1234
Practice Address - Fax:336-584-6811
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC33995207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1710942016OtherNPI
NC1710942016OtherNPI
1282880002Medicare NSC
NCF03991Medicare UPIN