DR. DOUGLAS MARTIN ELLINGER MD
NPI 1295793511
Radiology - Diagnostic Radiology in Grand Rapids, MI

Q: What is Douglas Ellinger's NPI number?

The NPI number for Douglas Ellinger is 1295793511. It was assigned to this individual provider in the NPPES registry on May 3, 2006.

Q: What is Douglas Ellinger's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Q: When was this NPI record last updated?

The NPPES record for Douglas Ellinger was last updated on June 16, 2009. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since May 03, 2006

3264 N EVERGREEN DR NE, GRAND RAPIDS, MI 49525(616) 363-7339(616) 361-5828 Get Directions Write a Review

NPPES record last updated: June 16, 2009. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Dr. Douglas Martin Ellinger Md NPPES

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

DR. DOUGLAS MARTIN ELLINGER MD (NPI 1295793511) is an individual diagnostic radiology provider in Grand Rapids, Michigan, licensed in Michigan (4301048999) and active in the NPI registry since May 2006.

NPPES Registry Identity

NPI1295793511

Entity TypeIndividualMale

Primary Taxonomy2085R0202X

Provider Legal NameDR. DOUGLAS MARTIN ELLINGERCredential: MD

Location Address3264 N EVERGREEN DR NEGrand Rapids, MI 49525-9746

Mailing Address3264 N Evergreen Dr NeGrand Rapids, MI 49525-9746 · (616) 363-7339 · Fax (616) 361-5828

Phone(616) 363-7339

Fax(616) 361-5828

Sole ProprietorNo

Enumeration DateMay 3, 2006

Last NPPES UpdateJune 16, 2009

✔ NPI 1295793511 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians

Taxonomy Code2085R0202X

License✔ Licensed in MI · 4301048999

Definition

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

3264 N EVERGREEN DR NE, Grand Rapids, MI 49525

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Other Identifiers 6

OtherDB9242MI · Medicare Rr Group Pin

Medicare UPINE94296

Other300E410190MI · Bcbs Group Pin

Medicaid4560935MI

Medicare PIN0N79940MI

Medicare ID-Type Unspecified0N79940002MI

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JAY A HAROLDS MD

Radiology (Diagnostic Radiology)