Individual
ELIZABETH EBY HALVORSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2011
Mailing address
PO BOX 602658, CHARLOTTE, NC 28260-2658
(336) 716-2011
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
2012-00431
NC
208M00000X
Hospitalist Physician
Primary
2012-00431
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1972739183
—
VA
05
—
3810023219
—
WV
05
—
5920541
—
NC
05
—
Q31012
—
SC
Enumeration date
06/02/2009
Last updated
07/09/2014
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