Individual
DR. JIM PATRICK ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-2375
(336) 716-6410
Mailing address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-6410
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
32955
AL
207RN0300X
Nephrology Physician
Primary
2021-00081
NC
Other
Enumeration date
06/29/2012
Last updated
08/10/2023
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