Ellison, Bradley S

Ellison, Bradley S is an individual health care provider with primary practice located at 354 Copperfield Blvd Ne , Concord NC 28025-2402. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Adult Reconstructive Orthopaedic Surgery, Allopathic & Osteopathic Physicians / Orthopaedic Surgery. Allopathic & Osteopathic Physicians / Orthopaedic Surgery is his primary health care specialty. Ellison, Bradley S can be contacted via phone (704) 323-2000.

Contact Information

Primary practice address
354 Copperfield Blvd Ne Concord NC 28025-2402
Phone: (704) 323-2000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adult Reconstructive Orthopaedic Surgery 207XS0114X 0101247812 Virginia
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 2015-01521 North Carolina

Profile Details

NPI number 1205037116
LBN Legal business name Ellison, Bradley S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 29th, 2007
Last updated Sep 24th, 2015 - about 9 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 1205037116 NPPES
North Carolina MEDICAID 1205037116
North Carolina MEDICAID Q0152N

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