Ellenwood, Clay

Ellenwood, Clay is an individual health care provider with primary practice located at 7232 Justin Way , Mentor OH 44060-4881. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Ellenwood, Clay can be contacted via phone (440) 578-8200.

Contact Information

Primary practice address
7232 Justin Way Mentor OH 44060-4881
Phone: (440) 578-8200
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 5601008913 Michigan
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 50.006802RX Ohio

Profile Details

NPI number 1588134456
LBN Legal business name Ellenwood, Clay
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 4th, 2018
Last updated Aug 19th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1588134456 NPPES
Michigan Other 5601008913 DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS

Popular Providers