Individual
DR. ELIZABETH SHANNON ELLIOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
5041 N ROYAL DR, TRAVERSE CITY, MI 49684-6986
(231) 935-0600
(231) 935-0613
Mailing address
1105 SIXTH ST, TRAVERSE CITY, MI 49684-2345
(231) 935-0600
(231) 935-0613
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
5101012067
MI
208M00000X
Hospitalist Physician
5101012067
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1013919109
NPI #
MI
05
—
4846781
—
MI
01
—
70-0-F32947-0
BCBS CPIN #
MI
Enumeration date
06/02/2005
Last updated
09/12/2024
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