Healthcare Provider Details

I. General information

NPI: 1790762300
Provider Name (Legal Business Name): ELISA GIL-PIRES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/23/2005
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6121 MONTROSE RD
ROCKVILLE MD
20852-4803
US

IV. Provider business mailing address

6121 MONTROSE RD
ROCKVILLE MD
20852-4803
US

V. Phone/Fax

Practice location:
  • Phone: 301-770-8377
  • Fax: 301-816-7716
Mailing address:
  • Phone: 301-770-8377
  • Fax: 301-816-7716

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number039874
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number039874
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: