Individual
DR. CHRYSTAL FAYE ELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
522 ALLEN ST, SUITE 101, TROY, NC 27371-2861
(910) 571-5510
(910) 571-5539
Mailing address
522 ALLEN ST, SUITE 101, TROY, NC 27371-2861
(910) 571-5510
(910) 571-5539
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2007-01048
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
145XR
BCBS
NC
05
—
5907325
—
NC
01
—
9073047
AETNA
—
01
—
FH1100265
FIRST CAROLINA CARE
—
Enumeration date
02/14/2007
Last updated
06/24/2013
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