Provider Demographics
NPI:1154480671
Name:ELIA, JAMES MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:MICHAEL
Last Name:ELIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:264 GRANITE RUN DR
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-6804
Mailing Address - Country:US
Mailing Address - Phone:717-721-8205
Mailing Address - Fax:717-721-8251
Practice Address - Street 1:264 GRANITE RUN DR
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601
Practice Address - Country:US
Practice Address - Phone:717-721-8205
Practice Address - Fax:717-721-8251
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD064125L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP002491OtherGATEWAY HEALTH PLAN
PA0016735880005Medicaid
PA00445190OtherHIGHMARK BLUE SHIELD
PA50070710OtherCAPITAL BLUE CROSS
PAP00730289OtherRAILROAD MEDICARE
PA50070710OtherCAPITAL BLUE CROSS
PA00445190OtherHIGHMARK BLUE SHIELD