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General NPI Number Information
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NPI Number | 1699970335
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Entity Type | Organization
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Legal Business Name | ELAINE M YOUNG MD INC
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Dates
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Enumeration Date | 06/20/2007
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Last Update Date | 05/19/2008
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Provider Practice Location Address
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Address Line | 1411 6TH AVE
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City | HUNTINGTON
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State | WV
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Zip | 25701
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Country | US
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Telephone | 304-525-6132
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Fax | 304-697-0471
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Provider Business Mailing Address
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Address Line | 1411 6TH AVE
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City | HUNTINGTON
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State | WV
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Zip | 25701
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Country | US
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Telephone | 304-525-6132
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Fax | 304-697-0471
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ELAINE M YOUNG
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Credential | MD
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Telephone | 304-525-6132
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207NP0225X
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Taxonomy Name | Pediatric Dermatology Physician
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License Number | 16077
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 207NS0135X
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Taxonomy Name | Procedural Dermatology Physician
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License Number | 16077
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License Number State | WV
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Taxonomy #3
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 16077
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License Number State | WV
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