Ellis, Charles Norman

Ellis, Charles Norman is an individual health care provider with primary practice located at 1500 East Medical Center Dr 1St Floor Taubman Ctr Recp B, Ann Arbor MI 48109-5314. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Ellis, Charles Norman can be contacted via phone (734) 936-4054.

Contact Information

Primary practice address
1500 East Medical Center Dr 1St Floor Taubman Ctr Recp B Ann Arbor MI 48109-5314
Phone: (734) 936-4054
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 4301039740 Michigan

Profile Details

NPI number 1053406793
LBN Legal business name Ellis, Charles Norman
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 4th, 2006
Last updated Mar 1st, 2012 - about 14 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 1053406793 NPPES
Michigan MEDICAID 1364958

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