Healthcare Provider Details

I. General information

NPI: 1477529378
Provider Name (Legal Business Name): ELIZABETH ISBISTER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/28/2006
Last Update Date: 07/02/2020
Certification Date: 07/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8845 CARATOKE HIGHWAY SUITE 3
HARBINGER NC
27941
US

IV. Provider business mailing address

1134 N ROAD ST STE 2
ELIZABETH CITY NC
27909-3365
US

V. Phone/Fax

Practice location:
  • Phone: 252-491-2245
  • Fax:
Mailing address:
  • Phone: 252-335-2923
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number01055513
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number99-00243
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: