Provider Demographics
NPI:1942227871
Name:GHIAUR, ELENA D (MD)
Entity Type:Individual
Prefix:
First Name:ELENA
Middle Name:D
Last Name:GHIAUR
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:PO BOX 418953
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-8953
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10085 RED RUN BLVD STE 306
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-4832
Practice Address - Country:US
Practice Address - Phone:410-581-7804
Practice Address - Fax:410-581-5753
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2011-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.087638207R00000X
MDD069608207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2680782Medicaid
MD419269900Medicaid
MD716L/174547ZEAYMedicare PIN
I59630Medicare UPIN
MD712L/174547YBPGMedicare PIN
OHGH2027701Medicare ID - Type Unspecified