Individual
ELIZABETH ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1250 E MARSHALL ST, RADIOLOGY, RICHMOND, VA 23298-5051
(804) 628-3580
(804) 628-3593
Mailing address
PO BOX 91734, RICHMOND, VA 23291-1734
(804) 358-6100
(804) 342-7619
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
0101230708
VA
390200000X
Student in an Organized Health Care Education/Training Program
0101230708
VA
Other
Enumeration date
05/18/2007
Last updated
10/02/2019
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