Provider Demographics
NPI:1548580368
Name:GELLIS, DAVID (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:GELLIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 NATE WHIPPLE HWY STE 101
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:RI
Mailing Address - Zip Code:02864-1403
Mailing Address - Country:US
Mailing Address - Phone:401-658-2020
Mailing Address - Fax:
Practice Address - Street 1:450 VETERANS MEMORIAL PKWY # 15B
Practice Address - Street 2:
Practice Address - City:EAST PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02914-5300
Practice Address - Country:US
Practice Address - Phone:401-434-3350
Practice Address - Fax:401-434-5230
Is Sole Proprietor?:No
Enumeration Date:2010-06-03
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ54527207R00000X
NH21872207R00000X
WAMD60749731207R00000X
CODR.0056950207R00000X
GA74959207R00000X
MA270640207R00000X
RIMD20035207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine