ELIZABETH ELLEN TILT M.D. NPI 1073566014

NPI Information

NPI: 1073566014
Provider Name: ELIZABETH ELLEN TILT, M.D.
Classification: Pediatrics - 208000000X
Entity Type: Individual
Address:
136 GATEWAY BLVD STE A
MOORESVILLE, NC
ZIP 28117
Phone: (704) 799-2878
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Elizabeth Ellen Tilt, M.D. is a pediatrics in Mooresville, NC. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. Elizabeth Ellen Tilt, M.D. NPI is 1073566014. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

136 GATEWAY BLVD STE A
MOORESVILLE, NC
ZIP 28117-608
Phone: (704) 799-2878
Fax: (704) 799-1627

The enumeration date for this NPI number is 5/19/2006 and was last updated on 7/24/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2080A0000X	Pediatrics	Adolescent Medicine	95-00744	NORTH CAROLINA	No
2	208000000X	Pediatrics		95-00744	NORTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	8983534	MEDICAID	NORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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