MEDICARE: MRS. ELIZABETH GIDUZ MSW, LCSW, MSRA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	C002063	NC

General Provider Information

NPI Number	:	1164666830
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ELIZABETH GIDUZ MSW, LCSW, MSRA

Provider Business Mailing Address
First Line	:	107 ELLSWORTH PL
Second Line	:
City	:	CHAPEL HILL
State	:	NC
Zip	:	27516-4624
Country	:	US
Telephone Number	:	919-967-1036
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 MARKET ST STE 112
Second Line	:
City	:	CHAPEL HILL
State	:	NC
Zip	:	27516-4493
Country	:	US
Telephone Number	:	919-969-9611
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/26/2009
Last Update Date	:	04/26/2009

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