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Individual
ELIZABETH M BOARD
Active
Individual
ELIZABETH M BOARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
042184
GA
174400000X
Specialist
042184
GA
207LP2900X
Pain Medicine (Anesthesiology) Physician
042184
GA
208D00000X
General Practice Physician
Primary
042184
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
042184
GA STATE LICENSE
GA
Enumeration date
09/24/2007
Last updated
01/15/2014
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