Individual
DR. SEAN ALFRED ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
301 E WENDOVER AVE STE 211, GREENSBORO, NC 27401-1232
(336) 832-3088
(336) 832-3080
Mailing address
1200 N ELM ST, GREENSBORO, NC 27401-1004
(336) 832-7000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
9501233
NC
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
9501233
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12317
PARTNERS MEDICARE
NC
01
—
30469
BCBS NC
NC
01
—
5423138
AETNA
NC
01
—
60902
MEDCOST
NC
05
—
8930469
—
NC
Enumeration date
04/13/2006
Last updated
08/18/2021
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