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Individual

CLARAS S ELLIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
8109 TIS WELL DRIVE, SUITE 511, ALEXANDRIA, VA 22306
(703) 799-9500
(703) 799-9502
Mailing address
PO BOX 37189, BALTIMORE, MD 21297-3189
(571) 423-5699
(571) 423-5698

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101264387
VA
207Q00000X
Family Medicine Physician
TRN22887
FL

Other

Enumeration date
05/17/2016
Last updated
08/04/2022
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