Individual
KATHLEEN MARILYN ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3333 SILAS CREEK PKWY, WINSTON SALEM, NC 27103-3013
(336) 210-7080
(336) 718-9622
Mailing address
PO BOX 60516, CHARLOTTE, NC 28260-0516
(336) 210-7080
(336) 718-9622
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2008-00982
NC
207RH0000X
Hematology (Internal Medicine) Physician
Primary
2008-00982
NC
207RX0202X
Medical Oncology Physician
200800982
NC
390200000X
Student in an Organized Health Care Education/Training Program
127497
NC
Other
Enumeration date
10/30/2007
Last updated
07/11/2024
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