Individual
CHAD ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6010 E W T HARRIS BLVD, CHARLOTTE, NC 28215-4084
(704) 208-4134
Mailing address
6010 E W T HARRIS BLVD, CHARLOTTE, NC 28215-4084
(704) 208-4134
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0010-08882
NC
Other
Enumeration date
03/12/2019
Last updated
03/01/2022
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