Individual
DALE J ELLENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
680 CENTRE ST, BROCKTON, MA 02302-3308
(508) 941-7458
(508) 941-6336
Mailing address
680 CENTRE ST, BROCKTON, MA 02302-3308
(508) 941-7009
(508) 941-6337
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
52689
MA
Other
Enumeration date
06/26/2006
Last updated
05/11/2011
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