| Doctor Name: | ELIZABETH ELLEN TILT |
| NPI Number: | 1073566014 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | 95-00744 |
| Business Practice Address: | 136 Gateway Blvd Ste A Mooresville, NC - 281175608 |
| Business Phone Number: | 7047992878 |
| Business Fax Number: | 7047991627 |
| Mailing Address: | 136 Gateway Blvd Ste A, MOORESVILLE |
| State: | NC |
| Postal Code: | 281175608 |
| Phone Number: | 7047992878 |
| Fax Number: | 7047991627 |
| NPI Enumeration Date: | 05/19/2006 |
| NPI Last Update Date: | 07/24/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2080A0000X |
| License Number: | 95-00744 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NC |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Pediatrics |
| Taxonomy Specialization: | Adolescent Medicine |
| Taxonomy Definition: | A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |