Individual
MR. MAURY RUBEN ELLENBERG
Active
Individual
MR. MAURY RUBEN ELLENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
4301034191
MI
208100000X
Physical Medicine & Rehabilitation Physician
Primary
4301034191
MI
208VP0000X
Pain Medicine Physician
4301034191
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4212207
—
MI
Enumeration date
10/10/2005
Last updated
12/29/2015
Update your record
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