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Individual

DR. BRADLEY S ELLISON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
354 COPPERFIELD BLVD NE, CONCORD, NC 28025-2402
(704) 323-2000
Mailing address
4601 PARK RD, SUITE 250, CHARLOTTE, NC 28209-3239
(704) 323-2000

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
2015-01521
NC
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
0101247812
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1205037116
NC
05
Q0152N
SC
Enumeration date
05/29/2007
Last updated
08/09/2024
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