Ellenbogen, Kenneth A

Ellenbogen, Kenneth A is an individual health care provider with primary practice located at 1250 E Marshall St Internal Medicine/Cardiology, Richmond VA 23298-5051. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology. Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology is his primary health care specialty. Ellenbogen, Kenneth A can be contacted via phone (804) 828-7565.

Contact Information

Primary practice address
1250 E Marshall St Internal Medicine/Cardiology Richmond VA 23298-5051
Phone: (804) 828-7565
Fax: (804) 828-6082
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 0101040591 Virginia
Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology 207RC0001X 0101040591 Virginia

Profile Details

NPI number 1508966706
LBN Legal business name Ellenbogen, Kenneth A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 25th, 2006
Last updated Dec 30th, 2022 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508966706 NPPES
Virginia MEDICAID 006027547

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