Individual
DR. ELLEN D DILLAVOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3000 NEW BERN AVE, RALEIGH, NC 27610-1231
(919) 350-8000
Mailing address
PO BOX 63362, CHARLOTTE, NC 28263-3362
(800) 782-6945
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
2015-01778
NC
2086S0129X
Vascular Surgery Physician
Primary
2015-01778
NC
2086S0129X
Vascular Surgery Physician
MD066225L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100966194
—
PA
Enumeration date
02/08/2006
Last updated
12/04/2025
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