# DR. MATTHEW ELLIS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1598739187
- **Gender:** Man
- **Credential:** DC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 3567 | OH | Yes |

## Other

- **Enumeration date:** 02/13/2006
- **Last updated:** 01/26/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000383249 | ANTHEM BC/BS | OH |
| 05 | — | 2600662 | — | OH |
| 01 | — | P00374677 | PALMETTO GBA MEDICARE RR | OH |