MR. HOWARD STEVEN ELLISON (NPI# 1962410464) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1962410464 |
Entity Type | Individual |
Full Name | MR. HOWARD STEVEN ELLISON |
Credential | MD |
Practice Address |
1010 East Freeway Drive Conyers GA 30094 |
Practice Telephone | 7709228222 |
Practice Fax Number | 7709222001 |
Mailing Telephone | 7709228222 |
Mailing Fax Number | 7709222001 |
Enumeration Date | 2006-08-03 |
Last Update Date | 2010-07-26 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207R00000X | Internal Medicine | 020695 | GA | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CAQH | 10588878 | 01 | |
GA | 000193586A | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023325107 | Howard Randolph Ellison II | Technician/Technologist | 132 E Fordham Rd, Bronx, NY 10468-5408 | 2010-09-09 |
Street Address |
1010 EAST FREEWAY DRIVE |
City | CONYERS |
State | GA |
Zip Code | 30094 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1164029054 | Darlene Fletcher | Counselor | 827 St. Clair Dr., Conyers, GA 30094 | 2020-10-05 |
1194363366 | Clara A Matthews | Physician Assistant | 1930 Windsor Creek Drive Sw, Conyers, GA 30094 | 2019-12-18 |
1659838571 | Sensitive Home Care Agency Inc. | PACE Provider Organization | 2225 Morning Dew, Conyers, GA 30094 | 2019-02-27 |
1679097992 | Sheira Dennis | Case Management | 3828 Martingale Dr Se, Conyers, GA 30094 | 2017-07-28 |
1730571399 | Wellness and Trauma Recovery Center | Counselor | 1775 Parker Rd. Building C, Suite 210, Conyers, GA 30094 | 2015-02-19 |
1760870612 | Michael Terrell | Technician/Technologist | 806 Cambridge Creek Dr, Conyers, GA 30094 | 2014-12-30 |
1538567466 | Jennifer Angela Johnson | Registered Nurse | 2240 Wren Rd Se, Conyers, GA 30094 | 2014-12-09 |
1225445208 | Wanda Marcella Rainey-reed | Counselor | 1453 Klondike Rd Sw Ste D, Conyers, GA 30094 | 2014-07-22 |
1508155268 | Nicklaus Trent Rice | Obstetrics & Gynecology | 2750 Owens Dr, Conyers, GA 30094 | 2011-04-04 |
1720219660 | Candace Alexander | Dentist | 863 Flat Shoals Rd Se, Suite C #220, Conyers, GA 30094 | 2009-07-27 |
Find all providers in zip 30094 |
Taxonomy Code | 207R00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528358280 | Camille Patrice Mclean | Internal Medicine | 2347 New Haven Pl, Conyers, GA 30094-3358 | 2011-04-14 |
1508186867 | Craig O'neil Campbell | Internal Medicine | 1525 Paceville Ct, Conyers, GA 30012-7125 | 2010-06-09 |
1982832739 | Gregory E. Jones | Internal Medicine | 1415 Milstead Ave Ne, Conyers, GA 30012 | 2009-06-30 |
1982845665 | Samuel Davis Mintlow | Internal Medicine | 3241 Lindas Cir Se, Conyers, GA 30013-2238 | 2009-03-10 |
1689730244 | Bassam Tome | Internal Medicine | 1277 Wellbrook Cir Ne, Suite C, Conyers, GA 30012-3873 | 2006-12-28 |
1437211703 | Eastside Internal Medicine, LLC | Internal Medicine | 2080 Eastside Dr, Suite A, Conyers, GA 30013-1953 | 2006-12-14 |
1457446189 | Mary Harris Stephens | Internal Medicine | 1301 Wellbrook Circle, Conyers, GA 30012-3873 | 2006-10-04 |
1457446171 | James Ransford De Give | Internal Medicine | 1301 Well Brook Circle, Conyers, GA 30012-3873 | 2006-10-04 |
1215028253 | Harmon Andrew Smith | Internal Medicine | 1080 Green St Sw, Conyers, GA 30012-5269 | 2006-09-27 |
1386735066 | East Metro Internal Medicine | Internal Medicine | 3641 Highway 20 Se, Suite A, Conyers, GA 30013-3064 | 2006-09-27 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.