Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | D0053101 | MD |
N | 207VG0400X | Gynecologist | D53101 | MD |
NPI | 1184736514 |
---|---|
Provider Name | Dr. Richard M Ellerkmann |
First Address | Philadelphia, PA 19182-4173 |
Second Address | Lutherville, MD 21093 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 30/06/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
102600300 | (05) | MD |
165L 188758YXT | MEDICARE (01) | MD |
G82882 | (02) | |
KJ43GY/68621301 | CAREFIRST MARYLAND (01) | MD |
KJ43GY/68621301 | CAREFIRST MD GBMC (01) | MD |
S140/0001 | CAREFIRST REGIONAL GBMC (01) | MD |
S1400001 | CAREFIRST REGIONAL GBMC (01) | MD |
X961 0014 | CAREFIRST BLUE CHOICE (01) | MD |