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NPI Code Detail

MEDICARE: STERLING ELLSWORTH MD

MEDICARE:   STERLING  ELLSWORTH  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
1207V00000XObstetrics & Gynecology Physician0101-057534VA

Other Identifiers

General Provider Information

NPI Number : 1326017476
Entity Type Code : Individual
Provider Name (Legal Business Name) : STERLING ELLSWORTH MD
Provider Business Mailing Address
First Line : 102 HIGHLAND AVE SE
Second Line : SUITE 303
City : ROANOKE
State : VA
Zip : 24013-2256
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 102 HIGHLAND AVE SE
Second Line : SUITE 303
City : ROANOKE
State : VA
Zip : 24013-2256
Country : US
Telephone Number : 540-985-9715
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2006
Last Update Date : 05/07/2008

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Directions to “ STERLING ELLSWORTH MD” Practice Location

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