# MR. DAVID WILLIAMS ELLIS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1386748747
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | MD026575E | PA | Yes |

## Other

- **Enumeration date:** 09/07/2006
- **Last updated:** 03/15/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0009476790001 | — | PA |
| 01 | — | 02725200 | CAPITAL BLUE CROSS | PA |
| 01 | — | 110013871 | RAILROAD MEDICARE | — |
| 01 | — | 1522001 | GATEWAY | — |
| 01 | — | 20009377 | AMERIHEALTH MERCY | — |
| 01 | — | 232364010 | TRICARE | — |
| 01 | — | EL446512 | HIGHMARK BLUE SHIELD | PA |