Individual
DR. TAMI FOUNTAIN-ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
7001 FOREST AVE STE 302, RICHMOND, VA 23230-1726
(804) 282-2655
(804) 282-0676
Mailing address
7001 FOREST AVE STE 302, RICHMOND, VA 23230-1726
(804) 282-2655
(804) 282-0676
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101102532
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010075823
—
VA
01
—
080190627
MEDICARE RAILROAD
VA
01
—
292416
ANTHEM
VA
01
—
C06695
GROUP PTAN
VA
Enumeration date
02/02/2006
Last updated
11/11/2025
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