Dillavou, Ellen D
Dillavou, Ellen D is an individual health care provider with primary practice located at 3000 New Bern Ave , Raleigh NC 27610-1231. She recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Surgery, which is considered as her primary health care specialty. Dillavou, Ellen D can be contacted via phone (919) 350-8000.Contact Information
Primary practice address
3000 New Bern Ave
Raleigh NC 27610-1231
Phone: (919) 350-8000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Vascular Surgery | 2086S0129X | MD066225L | Pennsylvania |
| Allopathic & Osteopathic Physicians / Vascular Surgery | 2086S0129X | 2015-01778 | North Carolina |
Profile Details
| NPI number | 1932172442 |
|---|---|
| LBN Legal business name | Dillavou, Ellen D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 8th, 2006 |
| Last updated | Aug 17th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1932172442 | NPPES |
| Pennsylvania | MEDICAID | 100966194 |
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