Individual
JOHN CHARLES ELLYN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
31 SMITH ST, CHARLESTON, SC 29401-1720
(843) 577-6506
Mailing address
31 SMITH ST, SUITE C, CHARLESTON, SC 29401-1720
(843) 577-6506
(843) 723-9835
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
11024
SC
Other
Enumeration date
08/31/2005
Last updated
09/26/2013
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