Healthcare Provider Details

I. General information

NPI: 1942821400
Provider Name (Legal Business Name): ELI TALIAFERRO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2020
Last Update Date: 07/15/2025
Certification Date: 07/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 MISSISSIPPI AVE SE
WASHINGTON DC
20020-6120
US

IV. Provider business mailing address

1801 MISSISSIPPI AVE SE
WASHINGTON DC
20020-6120
US

V. Phone/Fax

Practice location:
  • Phone: 202-436-3060
  • Fax: 202-436-3098
Mailing address:
  • Phone: 202-436-3060
  • Fax: 202-436-3098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD210011807
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: