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NPI Code Detail

MEDICARE: DR. ELIZABETH GENEVIEVE IRESON MD

MEDICARE:  DR. ELIZABETH GENEVIEVE IRESON  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
2208000000XPediatrics Physician35.144352OH

General Provider Information

NPI Number : 1205395241
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ELIZABETH GENEVIEVE IRESON MD
Provider Business Mailing Address
First Line : 3336 14TH ST NW
Second Line :
City : WASHINGTON
State : DC
Zip : 20010-2302
Country : US
Telephone Number : 202-476-5580
Fax Number :
Provider Business Practice Location Address
First Line : 3336 14TH ST NW
Second Line :
City : WASHINGTON
State : DC
Zip : 20010-2302
Country : US
Telephone Number : 202-476-5580
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2019
Last Update Date : 06/01/2023

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Directions to “ DR. ELIZABETH GENEVIEVE IRESON MD” Practice Location

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