# ELIZABETH L MATERA

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1346532918
- **Gender:** F
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 47594 | KY | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | 58997 | WI | — |

## Other

- **Enumeration date:** 05/13/2011
- **Last updated:** 09/22/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 47594 | KY MEDICAL LICENSE | KY |
| 05 | — | 7100313530 | — | KY |