| Organization Name: | DILIP ELANGBAM, M.D.,LLC |
| NPI Number: | 1184981854 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DILIP K ELANGBAM (DOCTOR) |
| Mailing Address: | 10 Shady Ln Suite 201 Muncy |
| State: | PA US |
| Postal Code: | 177568807 |
| Phone Number: | 5705464100 |
| Fax Number: | 5705464101 |
| NPI Enumeration Date: | 04/18/2012 |
| NPI Last Update Date: | 04/23/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | MD062088L |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |