Individual
CLARENCE O'NEIL ELLIS
Active
Individual
CLARENCE O'NEIL ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
27910
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0278J
BCBS
NC
01
—
206134F
MEDICARE LEGACY NUMBER
—
05
—
8930620
—
NC
05
—
N27910
—
SC
Enumeration date
04/05/2006
Last updated
02/17/2012
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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