Provider Demographics
NPI:1194949792
Name:RODELA, ELAINA (MD)
Entity type:Individual
Prefix:MRS
First Name:ELAINA
Middle Name:
Last Name:RODELA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3570 KEITH STREET NW
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37312-4309
Mailing Address - Country:US
Mailing Address - Phone:423-473-5038
Mailing Address - Fax:423-339-4833
Practice Address - Street 1:1800A ROSSVILLE AVE
Practice Address - Street 2:SUITE 7
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37408-1912
Practice Address - Country:US
Practice Address - Phone:423-531-6555
Practice Address - Fax:423-531-6565
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2015-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN38022207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G83536Medicare UPIN
3828745Medicare ID - Type Unspecified