Individual
RENEE R ELLERBROEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4637 121ST ST, URBANDALE, IA 50323-2311
(515) 655-7080
(515) 655-7090
Mailing address
4637 121ST ST, URBANDALE, IA 50323-2311
(515) 655-7080
(515) 655-7090
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
24490
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1041525
—
IA
Enumeration date
08/28/2006
Last updated
07/07/2023
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