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Individual
ELLEN D WILLIS
Active
Individual
ELLEN D WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
31983
MN
208M00000X
Hospitalist Physician
Primary
31983
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
312821100
—
MN
Enumeration date
02/20/2006
Last updated
01/30/2018
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