Ellis, Paul W
Ellis, Paul W is an individual health care provider with primary practice located at 2001 Randolph Rd , Charlotte NC 28207-1215. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Ellis, Paul W can be contacted via phone (704) 323-2000.Contact Information
Primary practice address
2001 Randolph Rd
Charlotte NC 28207-1215
Phone: (704) 323-2000
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 085-001823 | Illinois |
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 0010-07620 | North Carolina |
Profile Details
NPI number | 1174594873 |
---|---|
LBN Legal business name | Ellis, Paul W |
Credentials | Physician Assistant (PA) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jan 30th, 2006 |
Last updated | Mar 17th, 2018 - about 6 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1174594873 | NPPES |
Illinois | Other | P00612667 | RR MEDICARE |
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