Individual
LESLIE R ELLIS
Active
Individual
LESLIE R ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
2006-01475
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
143NE
BCBS
—
05
—
1790861128
—
VA
01
—
192031
MEDCOST
—
05
—
3810010756
—
WV
05
—
5905535
—
NC
01
—
7173908
AETNA
—
01
—
808453
PARTNERS
—
05
—
Q01785
—
SC
Enumeration date
10/27/2006
Last updated
05/07/2008
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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