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ELLIS, MATTHEW STEWART       
This verification service provides current data extracted by the Oklahoma State Board of Medical Licensure and Supervision (OSBMLS) from its own database. The data enclosed in the green box below is provided by and controlled entirely by the OSBMLS and therefore constitutes a primary source verification of licensure status as authentic as a direct inquiry to the OSBMLS. NPI# and hospital privileges (if any) are provided by the licensee and not verified.
Practice Address: SPARTANBURG FAMILY MEDICINE RESIDENCY PROGRAM
853 N CHURCH ST # 510
SPARTANBURG SC 29303

Address last updated on 11/4/2004
Phone #: (864) 560-6193
Fax #:
County: NOT OKLAHOMA
License: 24209
Dated: 11/4/2004
Expires: 11/1/2005
License Type: Medical Doctor
Specialty: Family Medicine
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: Ross Univ, Sch of Med, Roseau, Dominica
Graduated: 5 / 2002
CME Year: 2007
Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Certifications:
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
SPARTANBURG FAMILY MEDICINE RESIDENCY PROGRAM
853 N CHURCH ST # 510
SPARTANBURG SC 29303

Phone #: (864) 560-6193
Fax #:

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