Elite Medical Group PC
Internal Medicine in West Bloomfield, MI. Organization (NPI-2).
NPI number1801637293
StatusActive
Last updated in NPPESJun 1, 2024
Details
- NPI
- 1801637293
- Entity type
- Organization (NPI-2)
- Legal business name
- Elite Medical Group PC
- Organization subpart
- No
- Enumeration date
- Jun 1, 2024
- Certification date
- Jun 1, 2024
- Last updated
- Jun 1, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | – | – | Yes |
Practice location
3210 Pine Lake RdWest Bloomfield, MI 48324-1951
Phone 248-974-2511
Mailing address
3210 Pine Lake RdWest Bloomfield, MI 48324-1951
Phone 248-974-2511
Authorized official
Yousif Ishmail
Owner
2489742511
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