Provider Demographics
NPI:1831283076
Name:MAESER, ELIZABETH U (MD)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:U
Last Name:MAESER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 950202
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40295-0202
Mailing Address - Country:US
Mailing Address - Phone:502-588-9490
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:10210 WESTPORT RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40241-2148
Practice Address - Country:US
Practice Address - Phone:502-339-0444
Practice Address - Fax:502-339-1717
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2015-02-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY24095208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYK117900OtherMEDICARE PTAN -NCMA
KY64240955Medicaid