DR. RICHARD IRA ELLENBOGEN DO NPI 1093804619

NPI Information

NPI: 1093804619
Provider Name: DR. RICHARD IRA ELLENBOGEN, DO
Classification: Obstetrics & Gynecology - 207V00000X
Entity Type: Individual
Address:
4000 HIGHLAND ROAD
#120
WATERFORD, MI
ZIP 48328
Phone: (248) 682-2109
Get Directions

DR. Richard Ira Ellenbogen, DO is an obstetrics gynecology in Waterford, MI. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. DR. Richard Ira Ellenbogen, DO NPI is 1093804619. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4000 HIGHLAND ROAD
#120
WATERFORD, MI
ZIP 48328
Phone: (248) 682-2109
Fax: (248) 682-4769

The enumeration date for this NPI number is 10/12/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207V00000X	Obstetrics & Gynecology		5101006200	MICHIGAN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	E26574	MEDICARE UPIN
2	5633280161	MEDICARE ID-TYPE UNSPECIFIED

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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