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Individual

MR. DAVID MICHAEL ELLISON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2085 HENRY TECKLENBURG DR, CHARLESTON, SC 29414-7710
(843) 577-6957
(843) 577-6523
Mailing address
PO BOX 751874, CHARLOTTE, NC 28275-1874
(843) 402-5200
(843) 402-5296

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
14902
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00365928
RAILROAD MEDICARE
SC
05
TL3110
SC
Enumeration date
05/24/2006
Last updated
09/30/2025
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