| Rodney L. Ellis, Md, Pc | |
|
9811 Greenbelt Rd Suite 104 Lanham MD 20706-2215 | |
| (301) 552-3953 | |
| Not Available |
| Full Name | Rodney L. Ellis, Md, Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 9811 Greenbelt Rd, Lanham, Maryland |
| Authorized Official Name and Position | Rodney L Ellis (PRESIDENT) |
| Authorized Official Contact | 3015523953 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rodney L. Ellis, Md, Pc 9811 Greenbelt Rd Suite 104 Lanham MD 20706-2215 Ph: (301) 552-3953 | Rodney L. Ellis, Md, Pc 9811 Greenbelt Rd Suite 104 Lanham MD 20706-2215 Ph: (301) 552-3953 |
| NPI Number | 1245418110 |
|---|---|
| Provider Enumeration Date | 02/04/2008 |
| Last Update Date | 11/03/2011 |
| Medicare PECOS PAC ID | 6800871625 |
|---|---|
| Medicare Enrollment ID | O20040623001591 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245418110 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | D0021326 (Maryland) | Primary |
| Provider Name | Rodney Ellis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104986405 PECOS PAC ID: 7517942337 Enrollment ID: I20040628000652 |
| Provider Name | Ada Ndulaka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912251687 PECOS PAC ID: 5294987111 Enrollment ID: I20121128000446 |
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