Provider Demographics
NPI:1538362892
Name:WASHINGTON, ELIJAH NONE SR (M D)
Entity type:Individual
Prefix:DR
First Name:ELIJAH
Middle Name:NONE
Last Name:WASHINGTON
Suffix:SR
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 COLE DR
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29907-1675
Mailing Address - Country:US
Mailing Address - Phone:843-525-6689
Mailing Address - Fax:
Practice Address - Street 1:304 SCOTT ST
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29902-5557
Practice Address - Country:US
Practice Address - Phone:843-982-0705
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5896207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology