Individual
DR. CHARLOTTE L ELLENBOGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
3885 UPHAM ST, SUITE 200, WHEAT RIDGE, CO 80033-4880
(303) 425-9245
(303) 425-1378
Mailing address
PO BOX 1449, WHEAT RIDGE, CO 80034-1449
(303) 425-9245
(303) 425-1378
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
53322
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03611509
—
IL
Enumeration date
05/01/2006
Last updated
02/10/2020
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