Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
COLETTE MARK ELLIS, MD
ActiveCOLETTE MARK ELLIS, MD is a General Practice healthcare provider located in FAIRBORN, Ohio. NPI 1629530225 is currently active in the NPPES registry. Verify at CMS.
General Practice · FAIRBORN, OH
Registration Details
- NPI Number
- 1629530225
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Apr 2, 2019 (7.3845354643792 yrs)
- Last Updated
- Jul 27, 2022
- Licenses
-
S8030 (TX)S8030 (TX)
Practice Information
- Address
-
1059 BAYWOOD DRFAIRBORN, OH, 453242647Browse OH providers · Browse ZIP 45324
- Phone
- 7133390341
- Primary Specialty
-
General Practice
208D00000X
- Additional Specialty
- General Practice
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.