NPI 1386749695

Leland Calvin Ellis, PAC

Practitioner Medical Physician Assistant Winterville, NC

Practice location

Address: 324a Beacon Dr, Winterville, NC 28590-7956
Phone: (252) 551-5595
Fax: (252) 321-7762
Mailing address: 4076 Mobleys Bridge Rd, Grimesland, NC 27837-8999

Registered specialties

Medical Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363AM0700X Licence 103962 (NC)

Other Physician Assistant providers in North Carolina →

Registry record

NPI: 1386749695
Entity type: Individual
Sex (as registered): Male
NPI issued: 13 Sep 2006
Record last updated: 3 Jun 2008

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.