Individual
TEDD VINCENT ELLERBROCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1600 CLIFTON RD NE, ATLANTA, GA 30329-4018
(404) 639-8944
(404) 639-6499
Mailing address
477 MILLEDGE GATE TER SE, MARIETTA, GA 30067-3700
(404) 639-8944
(404) 639-6499
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
028973
GA
Other
Enumeration date
05/13/2008
Last updated
05/13/2008
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