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General NPI Number Information
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NPI Number | 1871152520
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Entity Type | Individual
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Provider Name | ELENA VLACHOS DO
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Gender | Female
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Dates
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Enumeration Date | 06/06/2019
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Last Update Date | 06/06/2019
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Provider Practice Location Address
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Address Line | 169 ASHLEY AVENEUE ROOM 202 MAIN HOSPITAL
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City | CHARLESTON
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State | SC
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Zip | 29425-0001
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Country | US
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Telephone | 843-792-4074
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Fax |
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Provider Business Mailing Address
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Address Line | 30989 PINE CONE DR
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City | FARMINGTON HILLS
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State | MI
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Zip | 48331-5901
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Country | US
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Telephone | 248-914-1742
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | LL82250
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License Number State | SC
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