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Individual

DAVID MARTIN ELWONGER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
300 W SOUTH AVE, #4708, WOODLAND PARK, CO 80866-7001
(719) 632-1502
Mailing address
845 SUN VALLEY DR, WOODLAND PARK, CO 80863-7729
(719) 632-1502

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
20946
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01209469
CO
Enumeration date
10/07/2005
Last updated
11/14/2016
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