Individual
DR. JEFFREY B ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1425 HORSHAM RD, MEDICAL SUITE, NORTH WALES, PA 19454-1320
(215) 815-7500
(877) 596-6460
Mailing address
1425 HORSHAM RD, MEDICAL SUITE, NORTH WALES, PA 19454-1320
(215) 815-7500
(877) 596-6460
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD072036L
PA
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
MD072036L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001848512
—
PA
01
—
232359401
MAIN LINE HEALTHCARE
PA
Enumeration date
02/02/2006
Last updated
07/15/2014
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