| Ellison & Associates Of Raleigh Pc | |
|
2920 Highwoods Blvd Suite 127 Raleigh NC 27604-1015 | |
| (919) 872-5220 | |
| (919) 872-5770 |
| Full Name | Ellison & Associates Of Raleigh Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2920 Highwoods Blvd, Raleigh, North Carolina |
| Authorized Official Name and Position | Maxlyn Lavie Ellison (PRESIDENT & CHIEF EXEC OFF) |
| Authorized Official Contact | 9198725220 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ellison & Associates Of Raleigh Pc 2920 Highwoods Blvd Suite 127 Raleigh NC 27604-1015 Ph: (919) 872-5220 | Ellison & Associates Of Raleigh Pc 2920 Highwoods Blvd Suite 127 Raleigh NC 27604-1015 Ph: (919) 872-5220 |
| NPI Number | 1396950630 |
|---|---|
| Provider Enumeration Date | 05/11/2007 |
| Last Update Date | 07/21/2008 |
| Medicare PECOS PAC ID | 9032351226 |
|---|---|
| Medicare Enrollment ID | O20130819000434 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396950630 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | (* (Not Available)) | Secondary |
| Provider Name | Maxlyn L Ellison |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386859627 PECOS PAC ID: 0547255176 Enrollment ID: I20040414001862 |
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