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WILLIAM MARTIN ELLIOTT II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
500 CHERRY ST, BLUEFIELD, WV 24701-3306
(304) 327-1100
Mailing address
4750 HEMPSTEAD STATION DR, KETTERING, OH 45429-5164
(800) 875-0136
(937) 619-4150

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
13508
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000143660
BLUE CROSS BLUE SHIELD
WV
01
001827970
BLUE CROSS BLUE SHIELD
WV
05
0056780000
WV
05
010283205
VA
01
1003314
BRICKSTREET
WV
01
3001609
BRICKSTREET
WV
01
P00309253
RR MEDICARE BLUEFIELD
Enumeration date
05/19/2006
Last updated
06/19/2013
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