Individual
DR. SHANNON BOLLING ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
400 MALL BLVD STE G, SAVANNAH, GA 31406-4820
(912) 644-5200
(912) 349-5691
Mailing address
815 OAK LANDING RD, JESUP, GA 31546-1518
(912) 424-2925
Taxonomy
Speciality
Code
Description
License number
State
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
073702
GA
Other
Enumeration date
01/30/2006
Last updated
01/25/2021
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