MEDICARE: DR. ELIZABETH MOTT MD

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	208M00000X	Hospitalist Physician	0101262930	VA

General Provider Information

NPI Number	:	1275956443
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELIZABETH MOTT MD

Provider Business Mailing Address
First Line	:	856 J CLYDE MORRIS BLVD STE A
Second Line	:
City	:	NEWPORT NEWS
State	:	VA
Zip	:	23601-1318
Country	:	US
Telephone Number	:	757-316-5900
Fax Number	:	757-534-5190

Provider Business Practice Location Address
First Line	:	PO BOX 430
Second Line	:
City	:	ONANCOCK
State	:	VA
Zip	:	23417-0430
Country	:	US
Telephone Number	:	757-302-2100
Fax Number	:

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

Provider Enumeration Date	:	01/24/2014
Last Update Date	:	01/24/2018

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