Ellis, John Wesley

Ellis, John Wesley is an individual health care provider with primary practice located at 2500 Hospital Drive , Martinsburg WV 25401. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Ellis, John Wesley can be contacted via phone (304) 264-1000.

Contact Information

Primary practice address
2500 Hospital Drive Martinsburg WV 25401
Fax: (304) 264-1374
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 16478 West Virginia
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 16478 West Virginia

Profile Details

NPI number 1275531436
LBN Legal business name Ellis, John Wesley
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 12th, 2005
Last updated Mar 30th, 2010 - about 14 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275531436 NPPES
Maryland MEDICAID 0052479000

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