MEDICARE: ELIZABETH A PROSSER M.D.,F.A.C.P.

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
1	207R00000X	Internal Medicine Physician	35-05-3562	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376549212
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH A PROSSER M.D.,F.A.C.P.

Provider Business Mailing Address
First Line	:	3515 MASSILLON RD
Second Line	:	STE 300
City	:	UNIONTOWN
State	:	OH
Zip	:	44685-6400
Country	:	US
Telephone Number	:	330-899-9350
Fax Number	:	330-634-1329

Provider Business Practice Location Address
First Line	:	1917 WILLIAMSBURG WAY NE
Second Line	:
City	:	LOUISVILLE
State	:	OH
Zip	:	44641-8781
Country	:	US
Telephone Number	:	330-875-3366
Fax Number	:	330-875-1106

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2005
Last Update Date	:	09/12/2016

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