NPI 1053406793

Charles Norman Ellis, MD

Practitioner Dermatology Physician Ann Arbor, MI

Practice location

Address: 1500 East Medical Center Dr 1st Floor Taubman Ctr Recp B, Ann Arbor, MI 48109-5314
Phone: (734) 936-4054
Mailing address: 3621 S State St 700 Kms Place, Ann Arbor, MI 48108

Registered specialties

Dermatology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207N00000X Licence 4301039740 (MI)

Other Dermatology providers in Michigan →

Registry record

NPI: 1053406793
Entity type: Individual
Sex (as registered): Male
NPI issued: 4 Oct 2006
Record last updated: 1 Mar 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.