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Individual
ELLIS A INGRAM
Active
Individual
ELLIS A INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
R6258
MO
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
R6258
MO
Other
Enumeration date
06/01/2006
Last updated
02/20/2008
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