Robert Arthur Ellwood, M.D.

Individual provider Active NPI General Practice Physician · Beverly Hills, MI

NPI 1619218971 · NPPES record last updated Mar 12, 2013

Key facts

NPI
1619218971
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Physician 208D00000X
License
4301034008 (MI)
Practice address
20046 Ronsdale Dr
Beverly Hills, MI 48025-3856
Phone
(248) 644-8281
NPI assigned
Mar 12, 2013
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301034008MIMDGeneral Practice Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 4301034008 MI Yes

Addresses

Primary practice location

20046 Ronsdale Dr
Beverly Hills, MI 48025-3856

Mailing address

20046 Ronsdale Dr
Beverly Hills, MI 48025-3856
Phone (248) 644-6261

Other providers in Beverly Hills, MI

All providers in Beverly Hills, MI · General Practice Physician in Michigan

Sources for this page

Verify at the official NPI Registry.