Individual
DR. NATHAN STEWART ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
480 CENTRAL AVE, JBPHH, HI 96860-4908
(808) 473-0650
Mailing address
480 CENTRAL AVE, JBPHH, HI 96860-4908
(808) 473-0650
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
18650
HI
2084P0804X
Child & Adolescent Psychiatry Physician
0101048223
VA
Other
Enumeration date
10/24/2005
Last updated
04/04/2025
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