Provider Demographics
NPI:1952657363
Name:ELIAS, RODERICK IAN (MD)
Entity Type:Individual
Prefix:DR
First Name:RODERICK
Middle Name:IAN
Last Name:ELIAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9735 KINCEY AVE.
Mailing Address - Street 2:SUITE 203
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078
Mailing Address - Country:US
Mailing Address - Phone:704-766-9050
Mailing Address - Fax:704-662-3458
Practice Address - Street 1:9735 KINCEY AVE STE 203
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-9120
Practice Address - Country:US
Practice Address - Phone:704-766-9050
Practice Address - Fax:704-662-3458
Is Sole Proprietor?:No
Enumeration Date:2012-08-03
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2017-016112084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology