Individual
LARS M ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
A83598
CA
208800000X
Urology Physician
Primary
MD17463
ME
Other
Enumeration date
12/06/2005
Last updated
05/20/2025
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