Individual
ADAM MICHAEL ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
550 UNIVERSITY BLVD RM 2180, INDIANAPOLIS, IN 46202-5149
(317) 944-2891
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01080411A
IN
207R00000X
Internal Medicine Physician
4301106054
MI
208M00000X
Hospitalist Physician
01080411A
IN
208VP0000X
Pain Medicine Physician
01080411A
IN
390200000X
Student in an Organized Health Care Education/Training Program
036149586
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201369900
—
IN
Enumeration date
06/16/2014
Last updated
12/03/2024
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