Ellmers, Brent Raymond
Ellmers, Brent Raymond is an individual health care provider with primary practice located at 1061 Harmon Ave , Fort Stewart GA 31314. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Ellmers, Brent Raymond can be contacted via phone (912) 435-6965.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 200000972389 | North Carolina |
Profile Details
| NPI number | 1255329454 |
|---|---|
| LBN Legal business name | Ellmers, Brent Raymond |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 11th, 2005 |
| Last updated | Feb 28th, 2024 - about 7 months 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 | 1255329454 | NPPES |
| Other | 1170Q | BCBS | |
| MEDICAID | 891170Q | BCBS |
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