Individual
DR. REUBEN KRISTIAN ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
055819
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
730346684AA
—
GA
05
—
730346684AB
—
GA
05
—
730346684AC
—
GA
05
—
730346684AD
—
GA
05
—
730346684G
—
GA
05
—
730346684J
—
GA
05
—
730346684K
—
GA
05
—
730346684M
—
GA
05
—
730346684N
—
GA
05
—
730346684O
—
GA
05
—
730346684P
—
GA
05
—
730346684Q
—
GA
05
—
730346684R
—
GA
05
—
730346684S
—
GA
05
—
730346684T
—
GA
05
—
730346684U
—
GA
05
—
730346684V
—
GA
05
—
730346684W
—
GA
05
—
730346684X
—
GA
05
—
730346684Y
—
GA
05
—
730346684Z
—
GA
Enumeration date
06/12/2006
Last updated
11/19/2020
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