Elle MD PLLC
Clinic/Center in Royal Oak, MI. Organization (NPI-2).
NPI number1295466720
StatusActive
Last updated in NPPESSep 24, 2022
Details
- NPI
- 1295466720
- Entity type
- Organization (NPI-2)
- Legal business name
- Elle MD PLLC
- Organization subpart
- No
- Enumeration date
- Jun 24, 2022
- Certification date
- Sep 24, 2022
- Last updated
- Sep 24, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | – | – | Yes |
Practice location
702 W 11 Mile RdRoyal Oak, MI 48067-2411
Phone 248-622-2694
Mailing address
702 W 11 Mile RdRoyal Oak, MI 48067-2411
Phone 248-284-6777
Authorized official
Erin Hendriks
Part-Owner
2486222694
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