Individual
STEPHEN G ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9500 EUCLID AVE, CLEVELAND, OH 44195-0001
(216) 445-6712
(216) 445-6714
Mailing address
9500 EUCLID AVE, J2-3, CLEVELAND, OH 44195-2139
(216) 445-6712
(216) 445-6714
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
35062492E
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0845198
—
OH
Enumeration date
10/03/2006
Last updated
03/10/2014
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