Individual
DR. DAVID PAUL ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., M.B.A
Contact information
Practice address
118 N 7TH AVE, SHELDON, IA 51201-1235
(712) 324-6366
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
24372020
WI
2085R0202X
Diagnostic Radiology Physician
Primary
39413
IA
2085R0202X
Diagnostic Radiology Physician
51095
MN
2085R0202X
Diagnostic Radiology Physician
7936
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23836
MEDICAL LICENSE
AZ
01
—
24372020
MEDICAL LICENSE
WI
05
—
435448000
—
MN
Enumeration date
02/07/2007
Last updated
12/19/2011
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