Individual
DR. ELIZABETH JOHNSON YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
300 KENTON DR, SUITE 100, CHARLESTON, WV 25311-1263
(304) 346-5533
(304) 346-5611
Mailing address
300 KENTON DR, SUITE100, CHARLESTON, WV 25311-1263
(304) 346-5533
(304) 346-5611
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
22972
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001706175
BLUE CROSS NUMBER FOR GROUP
WV
01
—
1447349238
NPI NUMBER FOR THE GROUP
WV
05
—
3810001081
—
WV
01
—
DC7713
UMWA NUMBER FOR GROUP
WV
01
—
P00189318
UMWA PIN NUMBER FOR GROUP
WV
01
—
P00215125
RAILROAD NUMBER FOR THE GROUP
WV
Enumeration date
04/24/2007
Last updated
08/07/2013
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