Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 01055189A | IN |
Y | 2080P0208X | Pediatric Infectious Diseases | 01055189A | IN |
NPI | 1023044385 |
---|---|
Provider Name | Robert Lloyd Elwood |
First Address | Usaf Academy, CO 80840-2502 |
Second Address | Usaf Academy, CO 80840-2502 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2006 |
Last Update Date | 13/03/2018 |