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Individual
CRAIG W. ELLIS
Active
Individual
CRAIG W. ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SC001626L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0069123000
HIGHMARK
PA
01
—
02320100
CAPITAL BLUE CROSS
PA
Enumeration date
06/30/2006
Last updated
06/22/2010
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