Individual
DR. LARRY NELSON ELAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10055 FORD AVE, STE 4A, RICHMOND HILL, GA 31324-3972
(912) 756-3075
(912) 756-5291
Mailing address
10055 FORD AVE, STE 4A, RICHMOND HILL, GA 31324-3972
(912) 756-3075
(912) 756-5291
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
053491
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
206521
BCBS RICHMOND HILL
GA
01
—
260521
BCBS SAVANNAH
GA
05
—
888120761A
—
GA
05
—
888120761B
—
GA
05
—
G53491
—
SC
Enumeration date
07/14/2005
Last updated
06/25/2008
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