Individual
MILTON BARRY ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
708 S SOUTH ST STE 300, MOUNT AIRY, NC 27030-4589
(336) 838-7758
(336) 838-9790
Mailing address
708 S SOUTH ST STE 300, MOUNT AIRY, NC 27030-4589
(336) 673-3125
(336) 838-9790
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
38757
NC
208600000X
Surgery Physician
38757
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8930638
—
NC
01
—
P00099783
RAILROAD MEDICARE
NC
Enumeration date
05/03/2006
Last updated
01/30/2020
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