Healthcare Provider Details
I. General information
NPI: 1073455366
Provider Name (Legal Business Name): DRELISABETHMIDLIFE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/07/2026
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
900 ARBORDALE AVE
HIGH POINT NC
27262-4626
US
IV. Provider business mailing address
PO BOX 5074
HIGH POINT NC
27262-5074
US
V. Phone/Fax
- Phone: 336-688-3498
- Fax:
- Phone: 336-916-3610
- Fax: 336-360-3563
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VG0400X |
| Taxonomy | Gynecology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ELISABETH
MARIE
STAMBAUGH
Title or Position: PHYSICIAN, OWNER, CEO
Credential: MD
Phone: 336-688-3498