Provider Demographics
NPI:1801826102
Name:NESBITT, ELIZABETH RUTH (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:RUTH
Last Name:NESBITT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46161 WESTLAKE DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:POTOMAC FALLS
Mailing Address - State:VA
Mailing Address - Zip Code:20165-5871
Mailing Address - Country:US
Mailing Address - Phone:703-433-9230
Mailing Address - Fax:703-433-9248
Practice Address - Street 1:46161 WESTLAKE DR
Practice Address - Street 2:SUITE 200
Practice Address - City:POTOMAC FALLS
Practice Address - State:VA
Practice Address - Zip Code:20165-5871
Practice Address - Country:US
Practice Address - Phone:703-433-9230
Practice Address - Fax:703-433-9248
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2012-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101053460207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010188661Medicaid
VA191639OtherANTHEM
VA008082L92Medicare PIN
VA010188661Medicaid