DR. GEORGE ELLIS JR. (NPI# 1366428484) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366428484 |
| Entity Type | Individual |
| Full Name | DR. GEORGE ELLIS JR. |
| Credential | M.D. |
| Practice Address |
910 Boardman-canfield Road Boardman OH 44512 |
| Practice Telephone | 3309650832 |
| Practice Fax Number | 3309650155 |
| Mailing Telephone | 3309650832 |
| Mailing Fax Number | 3309650155 |
| Enumeration Date | 2005-12-20 |
| Last Update Date | 2010-01-06 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | 35060641 | OH | Allopathic & Osteopathic Physicians |
| Y | 207R00000X | Internal Medicine | 35060641E | OH | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235347436 | George E Ellis | Dentist | 108 Trade Center Ln, Hazlehurst, MS 39083-2319 | 2007-05-19 |
| 1487729141 | George David Ellis | Psychiatry & Neurology | 3121 Route 38, Mount Laurel, NJ 08054-9725 | 2006-11-21 |
| 1891805834 | George Lewis Ellis | Dentist | 2650 Highway 109 Ste C, Grover, MO 63040-1163 | 2006-08-30 |
| 1699799841 | George Ellis | Family Medicine | 432 Rankin Drive, Marion, NC 28752 | 2006-07-27 |
| 1649242322 | George Arthur Ellis | Pharmacist | 26317 W Washington Street, Petersburg, VA 23803-0030 | 2006-02-06 |
| 1497873350 | George C Ellis | Internal Medicine | 1185 Park Avenue, # 1c, New York, NY 10128-1310 | 2007-03-27 |
| 1033144597 | George Frederick Ellis | Urology | 89 W Copeland Dr, Orlando, FL 32806-2002 | 2006-07-12 |
| 1700828613 | George S. Ellis Jr. | Ophthalmology | 200 Henry Clay Ave, Suite 3106, New Orleans, LA 70118-5720 | 2006-06-12 |
| 1508849175 | George L Ellis | Emergency Medicine | 1 Guthrie Sq, Sayre, PA 18840-1625 | 2005-11-28 |
| Street Address |
910 BOARDMAN-CANFIELD ROAD |
| City | BOARDMAN |
| State | OH |
| Zip Code | 44512 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285248740 | Kimberly Vrabel | Counselor | 725 Boardman Canfield Road Road Unit 1 and Unit 2, Boardman, OH 44512 | 2020-09-02 |
| 1043830144 | Steffi Lorraine D'souza | Student in an Organized Health Care Education/Training Program | 8423 Market Street Suite 101 St. Elizabeth Boardman Hos, Boardman, OH 44512 | 2020-04-20 |
| 1427677830 | Shivani Sharma | Family Medicine | 8423 Market Street Suite 101, St Elizabeth Boardman Hospital, Boardman, OH 44512 | 2020-04-15 |
| 1417587825 | Ronny Zetts | Pharmacist | 308 Boardman-canfield Rd, Boardman, OH 44512 | 2020-01-24 |
| 1285105080 | Andrew Dawson | Nurse Practitioner | 883 Boardman Canfield Rd Ste 105, Youngstown, OH 44512 | 2018-12-06 |
| 1700374949 | Adam Leid | Student in an Organized Health Care Education/Training Program | St Elizabeth Boardman Hospital - Medical Education Dept, 8401 Market Street, Boardman, OH 44512 | 2018-04-24 |
| 1528574910 | Herman Frank IIi | Licensed Practical Nurse | 920 Boardman Canfield Road, Boardman, OH 44512 | 2017-12-20 |
| 1730601980 | Stephanie Ann Mathews | Nurse Practitioner | 7600 Southern Blvd #1, Boardman, OH 44512 | 2017-07-10 |
| 1417485079 | Telka Ghobadi | Family Medicine | 8423 Market St., Suite 101, Boardman, OH 44512 | 2017-05-26 |
| 1356797534 | Haroon Hussain Syed | Student in an Organized Health Care Education/Training Program | 8423 Market Street, St. Elizabeth Boardman Hospital, Boardman, OH 44512 | 2016-05-06 |
| Find all providers in zip 44512 | ||||
| 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 |
|---|---|---|---|---|
| 1073708251 | George G Ellis Jr Md Inc | Internal Medicine | 910 Boardman Canfield Rd, Boardman, OH 44512-4240 | 2007-09-11 |
| 1013978808 | Thomas E Hunt | Internal Medicine | 7206 Market St Ste 100a, Boardman, OH 44512-4507 | 2006-03-31 |
| 1417930165 | Reema Taneja | Internal Medicine | 1280 Boardman Canfield Rd, Ste 3, Boardman, OH 44512-4073 | 2005-11-28 |
| 1023009412 | Keith Layne Henson | Internal Medicine | 8401 Market Street, C/o Medical Staff Office, Boardman, OH 44512 | 2005-11-03 |
| 1013900646 | Robert J Boss | Internal Medicine | 450 Tatone Street, Boardman, OR 97818 | 2005-08-30 |
| 1366449233 | Jayshree Rajesh Saraiya | Internal Medicine | 8401 Market St, Boardman, OH 44512 | 2005-07-06 |
| 1013911403 | Thomas Nicholas Detesco | Internal Medicine | 7341 Eisenhower Dr, Boardman, OH 44512-5900 | 2005-06-13 |
| 1083060404 | Amer Aldamouk | Internal Medicine | 8401 Market St, Boardman, OH 44512-6725 | 2016-05-05 |
| 1700231552 | Matar Matar | Internal Medicine | 8401 Market St, Boardman, OH 44512-6725 | 2016-04-29 |
| 1194135475 | Yacoub Baghdy | Internal Medicine | 8401 Market St, Boardman, OH 44512-6725 | 2014-05-07 |
| Find all providers in BOARDMAN | ||||
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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.