Provider Demographics
NPI:1982727913
Name:CULLER, ELIZABETH EDWARDS (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:EDWARDS
Last Name:CULLER
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 1:5600 LAKE RESORT TER
Mailing Address - Street 2:APT K440
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37415-2501
Mailing Address - Country:US
Mailing Address - Phone:423-752-5901
Mailing Address - Fax:
Practice Address - Street 1:705 EAST FOURTH STREET
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403
Practice Address - Country:US
Practice Address - Phone:423-875-5308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000040975207ZB0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZB0001XAllopathic & Osteopathic PhysiciansPathologyBlood Banking & Transfusion Medicine