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Individual

DAVID ELLIS DISBROW

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
6121 N THESTA ST STE 202, FRESNO, CA 93710-5294
(559) 440-0283
Mailing address
1 INDEPENDENCE PT STE 212, GREENVILLE, SC 29615-4536
(864) 797-6303

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
32837
SC
208C00000X
Colon & Rectal Surgery Physician
Primary
A148973
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
328372
SC
Enumeration date
04/28/2010
Last updated
08/18/2022
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