Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Richard Ira Ellenbogen, DO

Individual provider Obstetrics & Gynecology Physician · NPI 1093804619

Dr. Richard Ira Ellenbogen, DO is an Obstetrics & Gynecology Physician in Waterford, Michigan. Licensed in Michigan. Registered with an NPI since 2006.

Licensed in
MI
In the registry since
2006
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

4000 Highland Rd #120
Waterford, MI 48328
Phone: (248) 682-2109
Fax: (248) 682-4769
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Obstetrics & Gynecology Physician (primary) Taxonomy 207V00000X · Licence 5101006200 (MI)

Record details

NPI number1093804619
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedOctober 12, 2006
Last updated in NPPESJuly 8, 2007
Mailing address4000 Highland Road, 120, Waterford, MI 48328

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