| Doctor Name: | JUNE ESTHER ELCOCK-MESAM |
| NPI Number: | 1679506950 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | MD071892-L |
| Business Practice Address: | 401 Moore Rd Wallingford, PA - 190867049 |
| Business Phone Number: | 6105653336 |
| Business Fax Number: | 4843615938 |
| Mailing Address: | 401 Moore Rd, WALLINGFORD |
| State: | PA |
| Postal Code: | 190867049 |
| Phone Number: | 6105653336 |
| Fax Number: | 4843615938 |
| NPI Enumeration Date: | 07/09/2006 |
| NPI Last Update Date: | 08/26/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | MD071892-L |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |