Individual
JAMES MADISON ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7 INDEPENDENCE PT, STE 100, GREENVILLE, SC 29615-4566
(864) 797-6106
Mailing address
1 INDEPENDENCE PT, STE 212, GREENVILLE, SC 29615-4545
(864) 797-6044
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
030759
GA
207P00000X
Emergency Medicine Physician
Primary
31587
SC
207P00000X
Emergency Medicine Physician
35635
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
315876
—
SC
01
—
P00801506
RR MEDICARE
SC
Enumeration date
03/11/2009
Last updated
02/07/2015
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