Individual
MALINDA ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1634 E 63RD ST, KANSAS CITY, MO 64110-3502
(816) 381-5648
(816) 281-1871
Mailing address
PO BOX 740019, ATLANTA, GA 30374-0019
(312) 733-9730
(773) 866-8014
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2012003980
MO
207Q00000X
Family Medicine Physician
9407063
KS
Other
Enumeration date
07/10/2008
Last updated
12/31/2024
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