Provider Demographics
NPI:1801900816
Name:ELENER, VALERIE A (MD)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:A
Last Name:ELENER
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 1:2500 GRUBB RD
Mailing Address - Street 2:SUITE 212
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-4799
Mailing Address - Country:US
Mailing Address - Phone:302-475-5000
Mailing Address - Fax:302-475-5200
Practice Address - Street 1:2500 GRUBB RD
Practice Address - Street 2:SUITE 212
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810
Practice Address - Country:US
Practice Address - Phone:302-475-5000
Practice Address - Fax:302-475-5200
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0003339207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000452101Medicaid
DE0000452101Medicaid
F45964Medicare UPIN