Tina Marlene Ellis, PA

NPI #1053648436 in North Charleston, South Carolina

Provider Information

NPI Number: 1053648436
Entity Type: Individual
Name: Tina Marlene Ellis, PA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA
Enumeration Date: Nov 5, 2009
Last Updated: Jan 27, 2022

Practice Location

Address: 4969 CENTRE POINTE DR
Address 2: STE 100
City: North Charleston
State: South Carolina
ZIP Code: 29418-6952
Phone: (843) 853-0250

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant - Medical — Medical	363AM0700X
Physician Assistant	363A00000X	Primary

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