Provider Demographics
NPI:1285703892
Name:ELROD, MARILISA GIBELLATO (MD PHD)
Entity type:Individual
Prefix:DR
First Name:MARILISA
Middle Name:GIBELLATO
Last Name:ELROD
Suffix:
Gender:F
Credentials:MD PHD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:620 JOHN PAUL JONES CIR
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23708-2111
Mailing Address - Country:US
Mailing Address - Phone:757-953-5165
Mailing Address - Fax:757-953-7134
Practice Address - Street 1:620 JOHN PAUL JONES CIR
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23708-2111
Practice Address - Country:US
Practice Address - Phone:757-953-5652
Practice Address - Fax:757-953-7134
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2022-12-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA01012404402083P0011X, 2080P0006X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics
No2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics