Individual
DEE ANN ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6115 PARK SOUTH DRIVE, SUITE 100, CHARLOTTE, NC 28210-3281
(704) 554-8787
(704) 554-8774
Mailing address
6115 PARK SOUTH DRIVE, SUITE 100, CHARLOTTE, NC 28210-3281
(704) 554-8787
(704) 554-8774
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
14901
SC
207R00000X
Internal Medicine Physician
Primary
9300692
NC
Other
Enumeration date
11/02/2012
Last updated
11/02/2012
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