Individual
ELLIS A JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 HARNOIS AVE, WESTBROOK, ME 04092-4392
(207) 662-1340
(207) 662-1341
Mailing address
1 HARNOIS AVE STE 1B, WESTBROOK, ME 04092-4395
(207) 662-1340
(207) 662-1341
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD18827
ME
208M00000X
Hospitalist Physician
MD18827
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32000667
—
NH
Enumeration date
06/06/2008
Last updated
03/13/2025
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