Provider Demographics
NPI:1215931654
Name:GEORGE, ELIZABETH ANN (MD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:ANN
Last Name:GEORGE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:ANN
Other - Last Name:RUEDISUELI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:785 5TH AVENUE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-4232
Mailing Address - Country:US
Mailing Address - Phone:717-263-9555
Mailing Address - Fax:717-217-4218
Practice Address - Street 1:2 KEEFER DRIVE
Practice Address - Street 2:MERCERSBURG HEALTH CENTER
Practice Address - City:MERCERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17236-1732
Practice Address - Country:US
Practice Address - Phone:717-328-2115
Practice Address - Fax:717-328-4322
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-13
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD023513E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA080058982OtherRAILROAD MEDICARE
PA50014147OtherCAPITAL BLUECROSS
PA120420401OtherDEPT OF LABOR
PA427341OtherHEALTH AMERICA
PA4314403OtherAETNA NON-HMO
PA841849OtherAETNA HMO
PA000660530 0007Medicaid
PAMD023513EOtherLICENSE
PA2106632OtherMAMSI
PA25-1716306OtherGREATWEST
PA25-1716306OtherMULTIPLAN/PHCS
PA25-1716306OtherINTERGROUP
PAP003060OtherGATEWAY
PA144631OtherUNISON
PA25-1716306OtherINFORMED
PA25-1716306OtherSOUTH CENTRAL PREFERRED
PA25-1716306OtherDEVON
PA159862OtherHIGHMARK BLUE SHIELD
PA2160154OtherFIRST HEALTH
PA25-1716306OtherHEALTHNET/TRICARE
PA867633OtherMEDICARE GROUP #
PA867633OtherMEDICARE GROUP #
PA2106632OtherMAMSI
PAC32301Medicare UPIN