Individual
DR. JONATHAN MARK ELLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7676 NEW HAMPSHIRE AVE STE 220A, TAKOMA PARK, MD 20912-7514
(240) 297-6758
Mailing address
7676 NEW HAMPSHIRE AVE STE 220A, TAKOMA PARK, MD 20912-7514
(240) 297-6758
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
D54679
MD
208000000X
Pediatrics Physician
Primary
ME110221
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
472901300
—
MD
Enumeration date
06/08/2006
Last updated
08/12/2025
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