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Individual

DR. ELAINE C MACDOUGALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
104 SELMA DR, WINCHESTER, VA 22601-3834
(540) 678-2800
Mailing address
104 SELMA DR, WINCHESTER, VA 22601-3834
(540) 678-2800

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
101057755
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0045122000
WV
05
005616557
VA
01
020233
SOUTHERN HEALTH
VA
01
139296
ANTHEM BCBS
VA
01
2119587
MAMSI
VA
01
36996
SENTARA
VA
01
502800
NCPPO
VA
01
C00075
MEDICARE GROUP
VA
Enumeration date
07/26/2005
Last updated
09/03/2020
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