1356334643 NPI number — DR. ELSIE LEWIS TURNER MD

Table of content: DR. ELSIE LEWIS TURNER MD (NPI 1356334643)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356334643 NPI number — DR. ELSIE LEWIS TURNER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TURNER
Provider First Name:
ELSIE
Provider Middle Name:
LEWIS
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1356334643
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/30/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
13415 CONNECTICUT AVE
Provider Second Line Business Mailing Address:
#105
Provider Business Mailing Address City Name:
SILVER SPRING
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20906-2910
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-871-1228
Provider Business Mailing Address Fax Number:
301-871-1844

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13415 CONNECTICUT AVE
Provider Second Line Business Practice Location Address:
#105
Provider Business Practice Location Address City Name:
SILVER SPRING
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20906-2910
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-871-1228
Provider Business Practice Location Address Fax Number:
301-871-1844
Provider Enumeration Date:
08/23/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X , with the licence number:  D38233 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: B7730008 . This is a "CARE FIRST BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: H670 . This is a "CARE FIRST BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 177171000 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: B4290001 . This is a "BLUESHIELD NCA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 970040400 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8466 . This is a "BLUE SHIELD MD" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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