Organization
ELAN PLASTIC SURGERY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAIGE SMITH (CREDENTIALING MANAGER)
(301) 509-4091
Entity
Organization
Contact information
Practice address
15 WORMANS MILL CT STE L-M, FREDERICK, MD 21701-3019
(301) 698-2400
(301) 698-2460
Mailing address
15 WORMANS MILL CT STE L-M, FREDERICK, MD 21701-3019
(301) 698-2400
(301) 698-2460
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
D0037204
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
V6710001
CAREFIRST BLUECROSS BLUESHIELD
MD
Enumeration date
01/13/2012
Last updated
02/12/2021
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