Provider Demographics
NPI:1841297108
Name:ELLIOTT, DAVID P (PHARMD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:P
Last Name:ELLIOTT
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 BROOK RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25309-9222
Mailing Address - Country:US
Mailing Address - Phone:304-542-8956
Mailing Address - Fax:
Practice Address - Street 1:240 BROOK RD
Practice Address - Street 2:
Practice Address - City:SOUTH CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25309-9222
Practice Address - Country:US
Practice Address - Phone:304-542-8956
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP00044701835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy