Individual
DR. ROBERT STANFILL ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MPH
Contact information
Practice address
614 HOWARD STREET, ASU STUDENT HEALTH SERVICE, BOONE, NC 28607
(828) 262-3100
(828) 262-6262
Mailing address
PO BOX 32070, 614 HOWARD STREET, BOONE, NC 28608-2070
(828) 262-3100
(828) 262-6262
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
28181
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3404395
—
NC
Enumeration date
08/30/2006
Last updated
01/12/2010
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