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Individual

DR. DAVID JASON ELLENBOGEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
10035 PARK CEDAR DR STE 100, CHARLOTTE, NC 28210-8910
(704) 442-9011
(704) 625-9484
Mailing address
10035 PARK CEDAR DR STE 100, CHARLOTTE, NC 28210-8910
(704) 442-9011
(704) 625-9484

Taxonomy

Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
615
NC
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
615
NC
213ES0131X
Foot Surgery Podiatrist
615
NC

Other

Enumeration date
03/14/2007
Last updated
02/14/2023
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