Individual
DR. MICHAEL PAUL ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
562 GREGORY ST, BLACK HAWK, CO 80422
(303) 582-5276
(303) 582-1003
Mailing address
PO BOX 9, 20 E LAKEVIEW DR. SUITE 109, NEDERLAND, CO 80466-0009
(970) 945-2840
(303) 258-7140
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
50801
CO
Other
Enumeration date
02/27/2006
Last updated
12/12/2012
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