Individual
DR. MICHAEL N ELLEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
85 N GRAND AVE, FORT THOMAS, KY 41075-1793
(859) 572-3618
(859) 572-2366
Mailing address
PO BOX 18667, ERLANGER, KY 41018-0667
(859) 572-3617
(859) 572-2366
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01044634A
IN
207P00000X
Emergency Medicine Physician
Primary
31201
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20082410
—
IN
05
—
21708778
—
OH
05
—
64312010
—
KY
Enumeration date
07/17/2006
Last updated
05/28/2021
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