Male or Other

Clay Ellenwood PA-C

Medical Physician Assistant in Mentor, OH(View on Map)

Full Name

Clay Ellenwood PA-C

NPI Number

1588134456

NPI Type

Individual Provider

Gender

Male

Enumeration Date

12/04/2018

Specialties

(Taxonomies)

Code

363AM0700X

Primary Taxonomy

Yes

Licenses

State

Michigan
Ohio

License Number

5601008913
50.006802RX

Contact
Information

Purpose

Mailing
Location

Address

7232 JUSTIN WAY
7232 JUSTIN WAY

City

Mentor
Mentor

State

OH
OH

Postal Code

44060-4881
44060-4881

Country

US
US

Telephone Number

(440) 578-8200
(440) 578-8200

Identifiers

Identifier

5601008913

Identifier State

MI

Identifier Issuer

DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 08/19/2022

Provider Address

Other Medical Physician Assistants in Mentor, Ohio:

Male or Other

Jordan Smith PA-C

Mentor, OH

Specialty: Medical Physician Assistant (Primary)

Female

Kristi Meenan

Mentor, OH

Specialty: Medical Physician Assistant (Primary)

Female

Victoria Radel PA-C

Mentor, OH

Specialty: Medical Physician Assistant (Primary)

Female

Lisa Nedley PA-C

Mentor, OH

Specialty: Medical Physician Assistant (Primary)

Female

Sally Blum PA

Mentor, OH

Specialties: Medical Physician Assistant (Primary)Physician Assistant