Organization
JOHN F. ELLENBERG, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN F. ELLENBERG M.D. (PRESIDENT)
(912) 261-0447
Entity
Organization
Contact information
Practice address
2500 STARLING ST, 406, BRUNSWICK, GA 31520-4265
(912) 261-0447
(912) 261-1847
Mailing address
2500 STARLING ST, 406, BRUNSWICK, GA 31520-4265
(912) 261-0447
(912) 261-1847
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
021451
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000384315A
—
GA
Enumeration date
10/21/2010
Last updated
10/21/2010
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