Individual
DR. CHARLES ROBERT ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
109 BEE ST, CHARLESTON, SC 29401-5703
(843) 577-5011
Mailing address
109 BEE ST, CHARLESTON, SC 29401-5703
(843) 577-5011
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
27678
NC
2083A0100X
Aerospace Medicine Physician
27678
NC
2083X0100X
Occupational Medicine Physician
27678
NC
Other
Enumeration date
05/25/2006
Last updated
04/11/2016
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