Individual
DR. RICHARD M ELLERKMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1734 YORK ROAD, LUTHERVILLE PERSONAL PHYSICIANS, LUTHERVILLE, MD 21093
(410) 252-2273
Mailing address
PO BOX 824173, PHILADELPHIA, PA 19182-4173
Taxonomy
Speciality
Code
Description
License number
State
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
Primary
D0053101
MD
207VG0400X
Gynecology Physician
D53101
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102600300
—
MD
01
—
165L 188758YXT
MEDICARE
MD
01
—
KJ43GY/68621301
CAREFIRST MARYLAND
MD
01
—
S140/0001
CAREFIRST REGIONAL GBMC
MD
01
—
S1400001
CAREFIRST REGIONAL GBMC
MD
01
—
X961 0014
CAREFIRST BLUE CHOICE
MD
Enumeration date
08/31/2006
Last updated
06/30/2015
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