Organization
DAVID A. ELLIS, MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEANNA SHASTEEN ELLIS M.ED. (SECRETARY, OFFICE MANAGER)
(828) 698-5500
Entity
Organization
Contact information
Practice address
727 OAKLAND ST, HENDERSONVILLE, NC 28791-3647
(828) 698-5500
(828) 698-5503
Mailing address
727 OAKLAND ST, HENDERSONVILLE, NC 28791-3647
(828) 698-5500
(828) 698-5503
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
31499
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101G
BLUE CROSS BLUE SHIELD
NC
05
—
790101G
—
NC
01
—
DH 2191
RR MEDICARE
NC
Enumeration date
09/16/2006
Last updated
01/21/2010
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