Individual
DR. ELIZABETH ANN MELLENCAMP
Active
Individual
DR. ELIZABETH ANN MELLENCAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
LL88073
SC
207W00000X
Ophthalmology Physician
Primary
4301516763
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LL88073
SOUTH CAROLINA LIMITED MEDICAL LICENSE
SC
Enumeration date
06/13/2022
Last updated
07/16/2026
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