Individual
DR. ELENA N JDANOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
26677 W 12 MILE RD # B6, SOUTHFIELD, MI 48034-1514
(248) 354-4709
(248) 354-4807
Mailing address
4967 CROOKS RD, STE. 130, TROY, MI 48098-5801
(248) 952-1601
(248) 952-1614
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
EJ089660
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1073780292
—
MI
01
—
1346398971
GRP NPI
MI
01
—
EJ089660
LICENSE
MI
Enumeration date
05/15/2008
Last updated
09/29/2022
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