Healthcare Provider Details

I. General information

NPI: 1871533315
Provider Name (Legal Business Name): ELIZABETH E CAMPBELL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 07/02/2021
Certification Date: 07/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 ASHVILLE AVE STE 310
CARY NC
27518-8682
US

IV. Provider business mailing address

PO BOX 117287
ATLANTA GA
30368-7287
US

V. Phone/Fax

Practice location:
  • Phone: 919-233-8585
  • Fax:
Mailing address:
  • Phone: 239-785-3200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number27895
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number27895
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License Number27895
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: