Individual
HENRY M ELLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
201 WADSWORTH DR, RICHMOND, VA 23236-4510
(804) 285-8206
(804) 320-3102
Mailing address
2369 STAPLES MILL RD, SUITE 200, RICHMOND, VA 23230-2918
(804) 285-4465
(804) 285-8332
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
0101044338
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005875811
—
VA
Enumeration date
09/27/2005
Last updated
01/28/2010
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