Healthcare Provider Details

I. General information

NPI: 1760300347
Provider Name (Legal Business Name): ELIZABETH ANN KOLLER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 9513
SILVER SPRING MD
20916
US

IV. Provider business mailing address

PO BOX 9513
SILVER SPRING MD
20916
US

V. Phone/Fax

Practice location:
  • Phone: 240-506-0417
  • Fax:
Mailing address:
  • Phone: 240-506-0417
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number22284
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number26405
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: