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Individual

ZACH M ELLIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5801 BREMO RD, RICHMOND, VA 23226-1907
(804) 281-8100
Mailing address
PO BOX 5468, MARTINSVILLE, VA 24115-5468

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
0101049382
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10043603
OPTIMAHEALTH
VA
05
1962610931
VA
01
P00739839
RAILROAD MEDICARE
Enumeration date
05/21/2007
Last updated
05/26/2017
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