Doctor Name: | DR. JUSTIN DANIEL ELLETT |
NPI Number: | 1275827248 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD, PHD |
License Number: | MMD.33598 LL |
Business Practice Address: | 169 Ashley Ave Main Hospital Rm 202 Msc333 Charleston, SC - 294258905 |
Business Phone Number: | 8437923072 |
Business Fax Number: | |
Mailing Address: | 169 Ashley Ave, Main Hospital Rm 202 Msc333 CHARLESTON |
State: | SC |
Postal Code: | 294258905 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 06/07/2011 |
NPI Last Update Date: | 06/07/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208800000X |
License Number: | MMD.33598 LL |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Urology |
Taxonomy Specialization: | |
Taxonomy Definition: | A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |