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Contact Information

KENNETH A ELLENBOGEN, MD
1250 E MARSHALL ST
INTERNAL MEDICINE/CARDIOLOGY
RICHMOND, VA23298-5051
 Phone: 804-828-7565
 Fax: 804-828-6082
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical Cardiac Electrophysiology

207RC0001X 11 Physician/Internal Medicine
 

Cardiovascular Disease

207RC0000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for KENNETH A ELLENBOGEN · (Male)

NPI Number 1508966706
Status Active
Credentials MD
Entity Individual
Enumeration date 09/25/2006
Last updated 12/30/2022 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • VA License # 0101040591
  • VA Medicaid 006027547
Hospital affiliation(s)
  • MEDICAL COLLEGE OF VIRGINIA HOSPITALS - (Acute Care)
    1250 EAST MARSHALL STREET - BOX 980510
    RICHMOND, VA 23298
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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