Ellis, Paul W

Ellis, Paul W is an individual health care provider with primary practice located at 2001 Randolph Rd , Charlotte NC 28207-1215. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Ellis, Paul W can be contacted via phone (704) 323-2000.

Contact Information

Primary practice address
2001 Randolph Rd Charlotte NC 28207-1215
Phone: (704) 323-2000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 085-001823 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 0010-07620 North Carolina

Profile Details

NPI number 1174594873
LBN Legal business name Ellis, Paul W
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 30th, 2006
Last updated Mar 17th, 2018 - about 8 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 1174594873 NPPES
Illinois Other P00612667 RR MEDICARE

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