Individual
ELAINE M YOUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1411 6TH AVE, HUNTINGTON, WV 25701-2420
(304) 525-6132
(304) 697-0471
Mailing address
1411 6TH AVE, HUNTINGTON, WV 25701
(304) 525-6132
(304) 697-0471
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
16077
WV
207N00000X
Dermatology Physician
21723
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001721516
BLUE CROSS BLUE SHIELD
—
05
—
0069955000
—
WV
01
—
550724241
COMMERCIAL INSURANCE
—
Enumeration date
12/13/2005
Last updated
01/11/2012
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