Ellenoff, Bonnie P

Ellenoff, Bonnie P is an individual health care provider with primary practice located at 3640 Tramore Pointe Pkwy Kaiser Permanente West Cobb Medical Center, Austell GA 30106-6825. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Ellenoff, Bonnie P can be contacted via phone (770) 439-4700.

Contact Information

Primary practice address
3640 Tramore Pointe Pkwy Kaiser Permanente West Cobb Medical Center Austell GA 30106-6825
Fax: (404) 370-0428
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 051644 Georgia

Profile Details

NPI number 1306907001
LBN Legal business name Ellenoff, Bonnie P
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 13th, 2006
Last updated Jan 13th, 2022 - about 2 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 1306907001 NPPES
Georgia MEDICAID 0009593950

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