Individual
MS. NANCY SUE ELWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4315 MACCORKLE AVE SE, CHARLESTON, WV 25304-2503
(304) 926-8080
(304) 926-8083
Mailing address
4315 MACCORKLE AVE SE, CHARLESTON, WV 25304-2503
(304) 926-8080
(304) 586-1301
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
053140
GA
207Q00000X
Family Medicine Physician
Primary
23395
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316928344
—
WV
01
—
WV0542A
MEDICARE PIN
WV
Enumeration date
11/08/2005
Last updated
01/04/2023
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