1. Home
  2. Directory
  3. Michigan
  4. Waterford
  5. Obstetrics Gynecology
  6. NPI Profile

DR. RICHARD IRA ELLENBOGEN DO
NPI 1093804619
Obstetrics & Gynecology in Waterford, MI

Active since October 12, 2006
4000 HIGHLAND ROAD, #120, WATERFORD, MI 48328(248) 682-2109(248) 682-4769 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Richard Ira Ellenbogen Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. RICHARD IRA ELLENBOGEN DO (NPI 1093804619) is an individual obstetrics & gynecology provider in Waterford, Michigan, licensed in Michigan (5101006200) and active in the NPI registry since October 2006.

NPPES Registry Identity

NPI1093804619
Entity TypeIndividualMale
Primary Taxonomy207V00000X
Provider Legal NameDR. RICHARD IRA ELLENBOGENCredential: DO
Location Address4000 HIGHLAND ROAD, #120Waterford, MI 48328
Mailing Address4000 Highland Road, #120Waterford, MI 48328 · (248) 682-2109 · Fax (248) 682-4769
Phone(248) 682-2109
Fax(248) 682-4769
Sole ProprietorNo
Enumeration DateOctober 12, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1093804619 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
License✔ Licensed in MI · 5101006200
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
4000 HIGHLAND ROAD, Waterford, MI 48328
Open in Google Maps ↗

Other Identifiers 2

Medicare UPINE26574
Medicare ID-Type Unspecified5633280161

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Richard Ellenbogen's NPI number?

The NPI number for Richard Ellenbogen is 1093804619. It was assigned to this individual provider in the NPPES registry on October 12, 2006.

Where is Richard Ellenbogen located?

Richard Ellenbogen practices at 4000 Highland Road #120, Waterford, MI 48328. The listed phone number is (248) 682-2109.

What is Richard Ellenbogen's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

When was this NPI record last updated?

The NPPES record for Richard Ellenbogen was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.