Provider Demographics
NPI:1750346516
Name:WESTLY, ELIZABETH D (MD)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:D
Last Name:WESTLY
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 1689
Mailing Address - Street 2:
Mailing Address - City:ETOWAH
Mailing Address - State:NC
Mailing Address - Zip Code:28729-1689
Mailing Address - Country:US
Mailing Address - Phone:828-891-5524
Mailing Address - Fax:828-891-4069
Practice Address - Street 1:2161 HENDERSONVILLE RD
Practice Address - Street 2:STE C
Practice Address - City:ARDEN
Practice Address - State:NC
Practice Address - Zip Code:28704-7741
Practice Address - Country:US
Practice Address - Phone:828-684-1875
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC39228207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8986666Medicaid
NC8986666Medicaid
E55909Medicare UPIN