Individual
DR. EWELL MAYDELL HOLLIS III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3551 ROGER BROOKE DR, FORT SAM HOUSTON, TX 78234-4504
(210) 916-5586
Mailing address
PO BOX 9086, CAMP LEJEUNE, NC 28547-9086
(910) 451-0703
Taxonomy
Speciality
Code
Description
License number
State
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
0101230465
VA
208D00000X
General Practice Physician
0101230465
VA
Other
Enumeration date
01/31/2007
Last updated
06/30/2022
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