Individual
DR. HERMAN MARTIN ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 BIDDLE AVE STE 101, NEWARK, DE 19702-3982
(410) 505-8605
(240) 770-0436
Mailing address
9123 OLD ANNAPOLIS RD STE 203&204, COLUMBIA, MD 21045-1953
(410) 505-8605
(240) 770-0436
Taxonomy
Speciality
Code
Description
License number
State
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
Primary
C10007434
DE
2083P0901X
Public Health & General Preventive Medicine Physician
C1-0007434
DE
Other
Enumeration date
03/19/2007
Last updated
06/06/2023
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