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Individual

DR. ELISA M. MONTROSS-LOPEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD..

Contact information

Practice address
630 MULBERRY STREET, MILTON, DE 19968
(302) 684-8053
(302) 684-8059
Mailing address
640 S STATE ST, 742 BUILDING, DOVER, DE 19901-3530
(302) 674-3970
(302) 672-2350

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C1-0004991
DE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0000821101
DE
01
0002
CAREFIRST BCBS DC
DE
01
0420453000
AMERIHEALTH
DE
01
080107124
RAILROAD MEDICARE
DE
01
15RG73
BLUE CROSS BLUE SHIELD DE
DE
01
248021
MAMSI/UNITED HEALTH CARE
DE
01
47279
PRINCIPAL HEALTHCARE
DE
01
5728537
AETNA
DE
01
60953701
CAREFIRST BCBS
DE
Enumeration date
08/23/2005
Last updated
10/12/2012
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