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Individual
PAUL G. ELLERBECK
Active
Individual
PAUL G. ELLERBECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
25323
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05045
BCBS PROVIDER NUMBER
IA
Enumeration date
02/06/2006
Last updated
07/31/2013
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