Individual
JONATHAN ROBBINS ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 COMPASS WAY, SUITE 107, EAST BRIDGEWATER, MA 02333-1465
(508) 350-2400
(508) 350-2322
Mailing address
362 N BEDFORD ST, EAST BRIDGEWATER, MA 02333-1148
(508) 350-2350
(508) 350-2318
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
73826
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
073826
TAHP
MA
01
—
64909
HPHC
MA
01
—
CX9930
MEDICARE PTAN
MA
01
—
J11766
BC/BS
MA
Enumeration date
05/25/2006
Last updated
03/10/2011
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