Healthcare Provider Details

I. General information

NPI: 1629060116
Provider Name (Legal Business Name): ELIZABETH C TREFZGER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2005
Last Update Date: 02/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 W CRISER RD
FRONT ROYAL VA
22630-2360
US

IV. Provider business mailing address

123 AMHERST ST
WINCHESTER VA
22601-4137
US

V. Phone/Fax

Practice location:
  • Phone: 540-636-2931
  • Fax: 540-636-2933
Mailing address:
  • Phone: 540-662-0992
  • Fax: 540-662-1848

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number0101046704
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: