Ellison, Craig M

Ellison, Craig M is an individual health care provider with primary practice located at 4660 Kenmore Ave Suite #305, Alexandria VA 22304-1313. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Ellison, Craig M can be contacted via phone (703) 751-5763.

Contact Information

Primary practice address
4660 Kenmore Ave Suite #305 Alexandria VA 22304-1313
Phone: (703) 751-5763
Fax: (703) 370-8704
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X 0101234566 Virginia

Profile Details

NPI number 1932254083
LBN Legal business name Ellison, Craig M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 25th, 2007
Last updated Jan 9th, 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 1932254083 NPPES
District of Columbia Other P00777103 RR MEDICARE
District of Columbia MEDICAID 1932254083 RR MEDICARE

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