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Organization
SANDRA L ELLIS MD PLLC
Active
Organization
SANDRA L ELLIS MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA L ELLIS M.D. (OWNER)
(248) 353-2600
Entity
Organization
Contact information
Practice address
19034 W 10 MILE RD, SOUTHFIELD, MI 48075-2401
(248) 353-2600
Mailing address
19034 W 10 MILE RD, SOUTHFIELD, MI 48075-2401
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
SE070800
MI
Other
Enumeration date
01/13/2010
Last updated
01/13/2010
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