Dr Enrique Ellenbogen, MD | |
700 S Stanfield Rd, Suite B, Troy, OH 45373-2569 | |
(937) 335-7121 | |
(937) 335-7124 |
Full Name | Dr Enrique Ellenbogen |
---|---|
Gender | Male |
Speciality | Ophthalmology |
Location | 700 S Stanfield Rd, Troy, Ohio |
Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1972671709 | NPI | - | NPPES |
L0277598 | Medicaid | OH | |
000000010310 | Other | ANTHEM | |
311024334 | Other | OH | TAX IDENTIFICATION NUMBER |
D00246 | Other | HUMANA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207W00000X | Ophthalmology | 35100246 (Ohio) | Primary |
Mailing Address | Practice Location Address |
---|---|
Dr Enrique Ellenbogen, MD 700 S Stanfield Rd, Suite B, Troy, OH 45373-2569 Ph: (937) 335-7121 | Dr Enrique Ellenbogen, MD 700 S Stanfield Rd, Suite B, Troy, OH 45373-2569 Ph: (937) 335-7121 |
James R Rademacher, M.D. Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 180 S Stanfield Rd, Troy, OH 45373 Phone: 937-335-9020 Fax: 937-335-6684 |