Individual
MARCUS T ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1222 JEFFERSON PARK AVE, CHARLOTTESVILLE, VA 22903-3410
(434) 924-1931
(434) 244-4451
Mailing address
PO BOX 749112, ATLANTA, GA 30374-9112
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101282674
VA
Other
Enumeration date
04/10/2021
Last updated
07/10/2024
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