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Individual

DR. MICHAEL SYDNEY ELLIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1415 TULANE AVE, NEW ORLEANS, LA 70112-2600
(504) 988-5451
(504) 988-5948
Mailing address
1415 TULANE AVE, NEW ORLEANS, LA 70112-2600
(504) 988-5451
(504) 988-5948

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
010221
LA
207Y00000X
Otolaryngology Physician
Primary
MD.010221
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
09737205
MS
05
1101133
LA
05
1518961259
AL
Enumeration date
06/10/2005
Last updated
04/19/2017
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