Individual
DR. MICHAEL TODD ELLERBUSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4517 SOUTHLAKE PKWY, SUITE 202, BIRMINGHAM, AL 35244-3280
(205) 985-4111
(205) 985-4326
Mailing address
PO BOX 830791, BIRMINGHAM, AL 35283-0791
(205) 985-4111
(205) 985-4326
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
MD.21044
AL
2081N0008X
Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
MD.21044
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009933849
—
AL
01
—
56685
BCBS OF ALABAMA
AL
Enumeration date
05/05/2006
Last updated
05/09/2023
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