Provider Demographics
NPI:1174584668
Name:POWERS, ELIZABETH S (MD)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:S
Last Name:POWERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 ROSEMAR CIR
Mailing Address - Street 2:SUITE D
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26104-1203
Mailing Address - Country:US
Mailing Address - Phone:304-865-7700
Mailing Address - Fax:304-865-7703
Practice Address - Street 1:3 ROSEMAR CIR
Practice Address - Street 2:SUITE D
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26104-1203
Practice Address - Country:US
Practice Address - Phone:304-865-7700
Practice Address - Fax:304-865-7703
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV18410207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0079827000Medicaid
OH0253774Medicaid
WV0804534Medicare ID - Type Unspecified
OH0253774Medicaid