Provider Demographics
NPI:1891072633
Name:MIER-TROTTER, ELENA BEATRIZ (MD)
Entity Type:Individual
Prefix:
First Name:ELENA
Middle Name:BEATRIZ
Last Name:MIER-TROTTER
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 1:7924 WENTWORTH PL
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22152-3440
Mailing Address - Country:US
Mailing Address - Phone:703-451-0034
Mailing Address - Fax:
Practice Address - Street 1:11300 ROCKVILLE PIKE
Practice Address - Street 2:SUITE 1202
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-3003
Practice Address - Country:US
Practice Address - Phone:301-896-0890
Practice Address - Fax:301-896-0968
Is Sole Proprietor?:No
Enumeration Date:2011-11-08
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0050580207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDH53471Medicare UPIN