Ellis, Adam Michael
Ellis, Adam Michael is an individual health care provider with primary practice located at 550 University Blvd Rm 2180 , Indianapolis IN 46202-5149. He recently has 5 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospitalist, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Anesthesiology is his primary health care specialty. Ellis, Adam Michael can be contacted via phone (317) 944-2891.Contact Information
Primary practice address
550 University Blvd Rm 2180
Indianapolis IN 46202-5149
Phone: (317) 944-2891
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | 036149586 | Illinois |
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 01080411A | Indiana |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 4301106054 | Michigan |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | 01080411A | Indiana |
| Allopathic & Osteopathic Physicians / Pain Medicine | 208VP0000X | 01080411A | Indiana |
Profile Details
| NPI number | 1164836458 |
|---|---|
| LBN Legal business name | Ellis, Adam Michael |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 16th, 2014 |
| Last updated | Dec 3rd, 2024 - about 2 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 | 1164836458 | NPPES |
| Indiana | MEDICAID | 201369900 |
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