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Individual
ELLIOTT S ATTISHA
Active
Individual
ELLIOTT S ATTISHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
5101013649
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
433451311
—
MI
Enumeration date
06/02/2005
Last updated
04/30/2009
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