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Individual

OREN HENRY ELLIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1631 HOSPITAL DR, SUITE 200, SANTA FE, NM 87505-4728
(505) 424-0578
Mailing address
455 SAINT MICHAELS DR, MEDICAL STAFF OFFICE, SANTA FE, NM 87505-7601
(505) 820-5227

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
66-2
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10003858
LOVELACE
01
2335644
UHC
01
5421393
CCN
01
NM01VP02
BCBS NM
NM
01
PROVO13053
MOLINA
05
V7059
NM
Enumeration date
03/09/2006
Last updated
11/21/2007
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