Ellis, Lisa L

Ellis, Lisa L is an individual health care provider with primary practice located at 1250 E Marshall St Ob/Gyn, Richmond VA 23298-5051. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Ellis, Lisa L can be contacted via phone (804) 560-8950.

Contact Information

Primary practice address
1250 E Marshall St Ob/Gyn Richmond VA 23298-5051
Phone: (804) 560-8950
Fax: (804) 560-7343
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 5468 South Dakota
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 0101234748 Virginia

Profile Details

NPI number 1972508950
LBN Legal business name Ellis, Lisa L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 16th, 2005
Last updated Feb 26th, 2010 - about 16 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 1972508950 NPPES
South Dakota MEDICAID 6004870

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