Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | 0101251503 | VA |
NPI | 1750593612 |
---|---|
Provider Name | Elizabeth W Chance |
First Address | Baltimore, MD 21279-0777 |
Second Address | Charlottesville, VA 22911 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2007 |
Last Update Date | 26/06/2018 |