Bonnie P Ellenoff, DO
Family Medicine in Austell, GA. Individual provider (NPI-1).
NPI number1306907001
StatusActive
Last updated in NPPESJan 13, 2022
Details
- NPI
- 1306907001
- Entity type
- Individual (NPI-1)
- Name
- Bonnie P Ellenoff
- Credential
- DO
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 13, 2006
- Last updated
- Jan 13, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 051644 | GA | Yes |
Practice location
3640 Tramore Pointe PkwyKaiser Permanente West Cobb Medical Center
Austell, GA 30106-6825
Phone 770-439-4700 · Fax 404-370-0428
Mailing address
3495 Piedmont Rd NeNine Piedmont Center
Atlanta, GA 30305-1717
Phone 404-504-5678 · Fax 404-370-0428
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