Provider Demographics
NPI:1255644001
Name:SEGAL, ELLIOT A
Entity type:Individual
Prefix:
First Name:ELLIOT
Middle Name:A
Last Name:SEGAL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6931 ARLINGTON RD
Mailing Address - Street 2:SUITE 308
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-5231
Mailing Address - Country:US
Mailing Address - Phone:301-652-5001
Mailing Address - Fax:
Practice Address - Street 1:6931 ARLINGTON RD
Practice Address - Street 2:SUITE 308
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-5231
Practice Address - Country:US
Practice Address - Phone:301-652-5001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-22
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator