Individual
DAVID GARTH ELLERTSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2555 COURT DR STE 450, GASTONIA, NC 28054-2191
(704) 671-7652
(704) 671-7656
Mailing address
PO BOX 744786, ATLANTA, GA 30374-4786
(704) 834-2450
(704) 671-5331
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2005-01291
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1588657258
—
NC
Enumeration date
08/26/2005
Last updated
01/27/2020
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