National Provider Identifier Database

ELLIS I EFOBI, MD – NPI #1144487018
General Practice

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.


Contact Information

ELLIS I EFOBI, MD
1525 E. PARK PLACE BLVD.
SUITE 300
STONE MOUNTAIN, GA30087-3453
Phone: 770-879-7707
Fax: 770-879-7708
Website:
Specialty Taxonomy Code
* General Practice 208D00000X
Pain Medicine 2081P2900X

* Indicates primary specialty

NPI Profile & details for ELLIS I EFOBI

NPI Number 1144487018
Credentials MD
Entity Individual
Enumeration date 05/19/2008
Last updated 02/02/2011 - About 15 years ago
Sole proprietor1 No
Identifiers
  • GA License #: 060727
  • GA Medicaid: 594981959A
Hospital affiliation n/a

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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