Individual
DR. HERMAN ROY ELLEMBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3 MDG- SGOEE, 5955 ZEAMER AVE, ELMENDORF AFB, AK 99506
(907) 580-5555
Mailing address
5955 ZEAMER AVE, 3 MDG, SGOEE, ELMENDORF AFB, AK 99506-3702
(907) 580-5555
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
35-083393
OH
Other
Enumeration date
10/17/2005
Last updated
07/08/2007
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