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General NPI Number Information
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NPI Number | 1447531678
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Entity Type | Individual
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Provider Name | ELISHA E PETERSON M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/01/2011
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Last Update Date | 10/07/2024
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Provider Practice Location Address
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Address Line | 900 23RD ST NW
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City | WASHINGTON
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State | DC
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Zip | 20037-2342
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Country | US
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Telephone | 202-715-4750
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Fax |
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Provider Business Mailing Address
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Address Line | 28 Q ST NE APT 1
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City | WASHINGTON
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State | DC
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Zip | 20002-2474
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Country | US
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Telephone | 773-908-8966
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | Q9475
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | Q9475
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207LP3000X
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Taxonomy Name | Pediatric Anesthesiology Physician
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License Number | Q9475
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | MD046316
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License Number State | DC
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