# STEVEN R ELLISON

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

## Provider details

- **NPI number:** 1740267723
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 20730 | IA | Yes |

## Other

- **Enumeration date:** 12/29/2005
- **Last updated:** 05/22/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0159012 | — | IA |
| 01 | — | 110144445 | RR MEDICARE | IA |
| 05 | — | 1159012 | — | IA |
| 05 | — | 1740267723 | — | IA |
| 05 | — | 2159012 | — | IA |