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Individual
STEPHEN P ELLIOTT
Active
Individual
STEPHEN P ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
01047161A
IN
207Q00000X
Family Medicine Physician
Primary
89433
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01047161B
CSR
IN
01
—
DC3600
RAILROAD GROUP
IN
01
—
P00724943
RAILROAD INDIVIDUAL
IN
Enumeration date
08/10/2006
Last updated
06/29/2023
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