Dr. Charles Norman Ellis
Dermatologist
1500 East Medical Center Dr 1st Floor Taubman Ctr Recp B
Ann Arbor
, Michigan 48109-5314
Dr. Charles Norman Ellis
Dermatologist
1500 East Medical Center Dr 1st Floor Taubman Ctr Recp B
Ann Arbor
, Michigan 48109-5314
(734) 936-2047
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About
Features
Specialties
- Dermatologist
Languages spoken
- English
Location
First Address
- Dr. Charles Norman Ellis
- 3621 S State St 700 Kms Place
- Ann Arbor, MI
- Zip : 48108
- Phone : (734) 936-2047
Second Address
- Dr. Charles Norman Ellis
- 1500 East Medical Center Dr 1st Floor Taubman Ctr Recp B
- Ann Arbor, MI
- Zip : 48109-5314
- Phone : (734) 936-4054
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207N00000X | Dermatologist | 4301039740 | MI |
National Provider Identifier
| NPI | 1053406793 |
|---|---|
| Provider Name | Dr. Charles Norman Ellis |
| First Address | Ann Arbor, MI 48108 |
| Second Address | Ann Arbor, MI 48109-5314 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 04/10/2006 |
| Last Update Date | 01/03/2012 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1364958 | (05) | MI |
| B48295 | (02) | MI |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.