Organization
EL TAL MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ABDEL K EL TAL MD (PRESIDENT)
(313) 312-9050
Entity
Organization
Contact information
Practice address
555 MIDTOWNE ST NE STE 301, GRAND RAPIDS, MI 49503-5729
(616) 248-8864
(616) 248-8874
Mailing address
24330 ANN ARBOR TRL, DEARBORN HEIGHTS, MI 48127-1708
(313) 312-9050
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
4301089516
MI
Other
Enumeration date
07/13/2015
Last updated
07/13/2015
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