Provider Demographics
NPI:1881687440
Name:LEBEL, ELIZABETH ALISON (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:ALISON
Last Name:LEBEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ELIZABETH
Other - Middle Name:A
Other - Last Name:PATRICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:300 E MCBEE AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-2842
Mailing Address - Country:US
Mailing Address - Phone:864-522-8603
Mailing Address - Fax:
Practice Address - Street 1:1301 TAYLOR ST STE 8A
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-2955
Practice Address - Country:US
Practice Address - Phone:803-292-2955
Practice Address - Fax:803-929-2979
Is Sole Proprietor?:No
Enumeration Date:2005-08-29
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC22917207RH0002X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCT71491Medicaid
SCP00261520OtherRAILROAD MEDICARE
SCP00889617OtherMEDICARE RAILROAD
SCP00889617OtherMEDICARE RAILROAD
SCF930069615Medicare PIN
SCP00261520OtherRAILROAD MEDICARE