| 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 |