Provider Demographics
NPI:1386791242
Name:BUSKIRK, ELIZABETH JANE (MD)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:JANE
Last Name:BUSKIRK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:BUSKIRK
Other - Last Name:MARELLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1202 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-7307
Mailing Address - Country:US
Mailing Address - Phone:910-341-3000
Mailing Address - Fax:910-251-2067
Practice Address - Street 1:5211 S COLLEGE RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28412-2209
Practice Address - Country:US
Practice Address - Phone:910-341-3000
Practice Address - Fax:910-251-2067
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000044716208000000X
NC2012-01016208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics