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Individual

ELYSE LYNN MICHELSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
750 MAIN ST STE 205, REISTERSTOWN, MD 21136-2516
(410) 526-3041
(410) 584-1890
Mailing address
515 FAIRMOUNT AVE STE 400, TOWSON, MD 21286-8518
(410) 526-3041
(410) 584-1890

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D60680
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
403260800
MD
Enumeration date
05/08/2006
Last updated
12/07/2020
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