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Organization
CHARLOTTE LIMB PRESERVATION & DIABETIC FOOT CENTER PLLC
Active
Organization
CHARLOTTE LIMB PRESERVATION & DIABETIC FOOT CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID JASON ELLENBOGEN DPM, FACFAS (PRESIDENT)
(704) 442-9011
Entity
Organization
Contact information
Practice address
10035 PARK CEDAR DR STE 100, CHARLOTTE, NC 28210-8910
(917) 841-3619
Mailing address
2504 WHITNEY HILL RD, CHARLOTTE, NC 28226-4341
(917) 841-3619
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
—
NULL
213EP1101X
Primary Podiatric Medicine Podiatrist
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
NULL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
213ES0131X
Foot Surgery Podiatrist
—
NULL
213ES0131X
Foot Surgery Podiatrist
—
—
Other
Enumeration date
03/04/2022
Last updated
02/14/2023
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