=====================================================
General NPI Number Information
=====================================================
NPI Number | 1073455366
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DRELISABETHMIDLIFE, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/07/2026
-----------------------------------------------------
Last Update Date | 04/07/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 900 ARBORDALE AVE
-----------------------------------------------------
City | HIGH POINT
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27262-4626
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 336-688-3498
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 5074
-----------------------------------------------------
City | HIGH POINT
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27262-5074
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 336-916-3610
-----------------------------------------------------
Fax | 336-360-3563
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSICIAN, OWNER, CEO
-----------------------------------------------------
Name | ELISABETH MARIE STAMBAUGH
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 336-688-3498
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207VG0400X
-----------------------------------------------------
Taxonomy Name | Gynecology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------