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Individual

SANDRA Y ELLIOTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
3200 MACCORKLE AVENUE SE, CAMC OUTPATIENT CLINICS, CHARLESTON, WV 25304
(304) 388-5590
(304) 388-8238
Mailing address
3200 MACCORKLE AVENUE SE, OUTPATIENT CARE CLINIC, CHARLESTON, WV 25304
(304) 388-5590
(304) 388-8238

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
15724
WV
207RI0200X
Infectious Disease Physician
Primary
15724
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0075205000
WV
Enumeration date
09/27/2006
Last updated
03/07/2023
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