Healthcare Provider Details
I. General information
NPI: 1447298880
Provider Name (Legal Business Name): BETHANNE HILL ELBERT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/04/2006
Last Update Date: 05/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4444 GERMANNA HWY SUITE 310
LOCUST GROVE VA
22508-2035
US
IV. Provider business mailing address
4444 GERMANNA HWY SUITE 310
LOCUST GROVE VA
22508-2035
US
V. Phone/Fax
- Phone: 540-972-6222
- Fax: 540-972-6299
- Phone: 540-972-6222
- Fax: 540-972-6299
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | 0101057113 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: