Ellison, Matthew S

Ellison, Matthew S is an individual health care provider with primary practice located at 5635 W Fort St , Detroit MI 48209-3154. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / General Practice is his primary health care specialty. Ellison, Matthew S can be contacted via phone (313) 849-3920.

Contact Information

Primary practice address
5635 W Fort St Detroit MI 48209-3154
Phone: (313) 849-3920
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / General Practice 208D00000X 5101027064 Michigan

Profile Details

NPI number 1578185211
LBN Legal business name Ellison, Matthew S
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date May 16th, 2020
Last updated Sep 3rd, 2022 - about 4 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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