Individual
CHARLES ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 BLYTHE BLVD, CHARLOTTE, NC 28203-5812
(704) 446-9243
Mailing address
550 W KINGSTON AVE, CHARLOTTE, NC 28203-4306
(208) 721-2622
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
261182
NC
Other
Enumeration date
03/29/2020
Last updated
03/29/2020
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