Individual
ELIE C ELLENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1201 S GRAND BLVD, SAINT LOUIS, MO 63104-1016
(314) 257-8000
Mailing address
934 W HURON ST, ANN ARBOR, MI 48103-4216
(248) 514-1344
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/01/2020
Last updated
03/24/2021
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