Individual
DR. MAZEN ELATRACHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
19401 HUBBARD DR, HENRY FORD FAIRLANE MEDICAL CENTER, DEARBORN, MI 48126
(313) 982-9307
(313) 982-8320
Mailing address
19401 HUBBARD DR, HENRY FORD FAIRLANE MEDICAL CENTER, DEARBORN, MI 48126
(313) 982-9307
(313) 982-8320
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301098217
MI
207RG0100X
Gastroenterology Physician
Primary
4301098217
MI
Other
Enumeration date
05/06/2011
Last updated
02/09/2023
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