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General NPI Number Information
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NPI Number | 1285787341
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Entity Type | Individual
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Provider Name | TREVOR ASHTON ELLISON M.D., PH.D., MBA
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Gender | Male
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Dates
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Enumeration Date | 01/19/2007
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Last Update Date | 11/24/2025
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Provider Practice Location Address
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Address Line | 1800 ORLEANS STREET SUITE 7107
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City | BALTIMORE
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State | MD
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Zip | 21287-4618
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Country | US
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Telephone | 410-955-9780
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Fax |
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Provider Business Mailing Address
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Address Line | 3000 ARLINGTON AVE STOP 1108
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City | TOLEDO
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State | OH
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Zip | 43614-2595
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Country | US
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Telephone | 419-383-7100
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 35.134693
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | T4123
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License Number State | MD
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