Individual
DR. ASHLEY GARNER ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3333 BROOKVIEW HILLS BLVD, WINSTON SALEM, NC 27103-5661
(336) 765-5250
(336) 659-0953
Mailing address
100 KIMEL FOREST DR, WINSTON SALEM, NC 27103-6074
(336) 716-1331
(336) 716-3202
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2018-02364
NC
2084P0800X
Psychiatry Physician
2018-02364
NC
2084P0800X
Psychiatry Physician
MD.206753
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00580093
—
MS
05
—
2193066
—
LA
Enumeration date
04/23/2012
Last updated
04/30/2021
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