Matthew S Ellison, DO - Detroit, MI

Matthew S Ellison, DO

General Practice Physician in Detroit, Michigan

NPI 1578185211

Matthew S Ellison is a General Practice Physician based in Southfield, MI. Matthew S Ellison practices in Detroit, MI and has the professional credentials of DO. The NPI Number for Matthew S Ellison is 1578185211 and holds a License No. (Michigan).

The current practice location address for Matthew S Ellison is 5635 W Fort St, Detroit, MI and can be reached out via phone at 313-849-3920.

Location: 5635 W Fort St, Detroit, MI, 48075-5346

NPI Number

1578185211

Provider Name

Matthew S Ellison

Credential

Provider Entity Type

Individual

Gender

Male

Address

5635 W Fort St, Detroit, MI, 48075-5346

Phone Number

313-849-3920

Fax Number

Provider Enumeration Date

05/16/2020

Last Update Date

03/10/2024

Address

5635 W Fort St

City

Detroit

State

Michigan

Zip

48209-3154

Phone Number

313-849-3920

Fax Number

Address

5635 W Fort St

City

Detroit

State

Michigan

Zip

48209-3154

Phone Number

313-849-3920

Fax Number

Type

Allopathic & Osteopathic Physicians

Classification

General Practice

Speciality

Taxonomy

208D00000X

License No.

5101027064 (Michigan)

Definition

Definition to come...

Type

Student, Health Care

Classification

Student in an Organized Health Care Education/Training Program

Speciality

Taxonomy

390200000X

License No.

()

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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