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Contact Information

WILLIAM D ELLIS, MD
8300 CONSTITUTION AVE NE
PMG EMERGENCY MEDICINE
ALBUQUERQUE, NM87110-7613
 Phone: 505-291-2122
 Fax: 505-291-2979
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for WILLIAM D ELLIS · (Male)

NPI Number 1790050128
Status Active
Credentials MD
Entity Individual
Enumeration date 03/19/2012
Last updated 03/16/2015 - About 11 years ago
Sole proprietor 1 No
Identifiers
  • NM License # 390200000
  • NM License # MD2015-0028
Hospital affiliation(s)
  • GENESYS REGIONAL MEDICAL CENTER - HEALTH PARK - (Acute Care)
    ONE GENESYS PARKWAY
    GRAND BLANC, MI 48439
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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