Blank, Ellen L
Blank, Ellen L is an individual health care provider with primary practice located at 9000 W Wisconsin Ave Pediatric Gastroenterology, Milwaukee WI 53226-4874. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Gastroenterology, which is considered as her primary health care specialty. Blank, Ellen L can be contacted via phone (414) 266-3690.Contact Information
Primary practice address
9000 W Wisconsin Ave Pediatric Gastroenterology
Milwaukee WI 53226-4874
Phone: (414) 266-3690
Fax: (414) 266-3676
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatric Gastroenterology | 2080P0206X | 22293 | Wisconsin |
Profile Details
| NPI number | 1801847249 |
|---|---|
| LBN Legal business name | Blank, Ellen L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 12th, 2006 |
| Last updated | Feb 1st, 2013 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1801847249 | NPPES |
| Wisconsin | MEDICAID | 1801847249 | |
| Wisconsin | Other | 008006261Q |
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