Provider Demographics
NPI:1720006547
Name:ELY, RALPH L III (MD)
Entity Type:Individual
Prefix:DR
First Name:RALPH
Middle Name:L
Last Name:ELY
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:3940 ARROWHEAD BLVD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:MEBANE
Mailing Address - State:NC
Mailing Address - Zip Code:27302-7636
Mailing Address - Country:US
Mailing Address - Phone:919-304-1081
Mailing Address - Fax:
Practice Address - Street 1:3940 ARROWHEAD BLVD
Practice Address - Street 2:SUITE 230
Practice Address - City:MEBANE
Practice Address - State:NC
Practice Address - Zip Code:27302-7636
Practice Address - Country:US
Practice Address - Phone:919-304-1081
Practice Address - Fax:919-304-1083
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2013-01-30
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Provider Licenses
StateLicense IDTaxonomies
NC31981208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2104OtherWELLPATH
NC7930649Medicaid
NC9903OtherPARTNERS
NCAE8454225OtherVETERANS ADMIN
NC5605209903OtherCIGNA
NC251917OtherMAMSI
NC56116OtherMEDCOST
NC17-02-058OtherUHC
NC30649OtherBCBS
NC2104OtherWELLPATH
NC251917OtherMAMSI