Individual
DR. PAUL DEVERE ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11459 JOHNS CREEK PKWY, STE 250, JOHNS CREEK, GA 30097-3517
(770) 497-1555
(770) 497-9998
Mailing address
11459 JOHNS CREEK PKWY, STE 250, JOHNS CREEK, GA 30097-3517
(770) 497-1555
(770) 497-9998
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
041549
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00701918B
—
GA
Enumeration date
08/02/2006
Last updated
05/05/2016
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