Individual
SHAWN MICHAEL ELLIS
Active
Individual
SHAWN MICHAEL ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
04757
OK
208VP0014X
Interventional Pain Medicine Physician
Primary
04757
OK
Other
Enumeration date
06/13/2008
Last updated
05/09/2014
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