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Individual

DR. MICHAEL A ELLERMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
640 JACKSON ST, SAINT PAUL, MN 55101-2502
(651) 254-4887
Mailing address
9200 W WISCONSIN AVE STE 300, MILWAUKEE, WI 53226-3522
(414) 805-6000
(414) 805-6280

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
79916
MN
207RC0000X
Cardiovascular Disease Physician
81478
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1235661117
WI
Enumeration date
03/30/2017
Last updated
07/14/2025
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