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Individual

DR. AMANDA STORM ELSTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1210 ASHLAND AVE, ZANESVILLE, OH 43701-2806
(740) 454-8551
(740) 454-2411
Mailing address
860 BETHESDA DR, ZANESVILLE, OH 43701-1800
(740) 454-4651
(740) 454-4653

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35047459E
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000018842
ANTHEM PIN
OH
01
000000177592
UNISON PIN
OH
01
0493360
UHC PIN
OH
05
0564394
OH
01
0989499
GROUP MEDICAID
OH
01
110094948
MEDICARE RAILROAD
OH
01
311413469056
CARESOURCE PIN
OH
01
CA0426
GROUP MEDICARE RAILROAD
OH
Enumeration date
12/14/2005
Last updated
03/19/2009
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