Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. MARK J ELLIS
Active Sole ProprietorMR. MARK J ELLIS is a 2278G1100X healthcare provider located in HAGERSTOWN, Maryland. NPI 1336204171 is currently active in the NPPES registry. Verify at CMS.
2278G1100X · HAGERSTOWN, MD
Registration Details
- NPI Number
- 1336204171
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Dec 22, 2006 (19.683458499251 yrs)
- Last Updated
- Jul 8, 2007
- License
-
YM005079L (MD)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1101 JEFFERSON BLVDHAGERSTOWN, MD, 217425037Browse MD providers · Browse ZIP 21742
- Phone
- 3017140200
- Fax
- 3017398533
- Primary Specialty
-
2278G1100X
2278G1100X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.