Individual
ELIJAH GORDON WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
60 MEMORIAL MEDICAL PKWY STE 2801, PALM COAST, FL 32164-5980
(386) 586-1910
Mailing address
60 MEMORIAL MEDICAL PKWY, PALM COAST, FL 32164-5980
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9113266
FL
Other
Enumeration date
09/22/2014
Last updated
06/09/2020
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