Individual
CATHERINE JONNAKUTY ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
19450 DEERFIELD AVENUE, SUITE 200, LEESBURG, VA 20176-6821
(703) 844-8380
(703) 263-8393
Mailing address
224D CORNWALL ST NW STE 403, LEESBURG, VA 20176-2704
(703) 737-6010
(571) 291-9786
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
0101259955
VA
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
MT189022
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1548473150
—
VA
05
—
30015941210002
—
VA
Enumeration date
05/08/2007
Last updated
10/09/2023
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