Individual
ROBERT G ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
400 BALD HILL RD, STE 520, WARWICK, RI 02886-1692
(401) 793-8520
(401) 793-8527
Mailing address
400 BALD HILL RD, STE 520, WARWICK, RI 02886-1692
(401) 793-8520
(401) 793-8527
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD04969
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2071151
—
MA
05
—
RE04322
—
RI
Enumeration date
06/27/2005
Last updated
09/07/2007
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