Provider Demographics
NPI:1851527402
Name:DEWITT, ELIZABETH STRACK (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:STRACK
Last Name:DEWITT
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:9 ALBEMARLE ST APT 5
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-4922
Mailing Address - Country:US
Mailing Address - Phone:617-276-5070
Mailing Address - Fax:
Practice Address - Street 1:300 LONGWOOD AVE
Practice Address - Street 2:DEPARTMENT OF CARDIOLOGY
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-5724
Practice Address - Country:US
Practice Address - Phone:617-355-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-09
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA2506152080P0202X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology