Individual
ELLIOT WAKEAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 E MEDICAL CENTER DR, ANN ARBOR, MI 48109-5000
(734) 936-4000
Mailing address
1500 E MEDICAL CENTER DR, ANN ARBOR, MI 48109-5000
(734) 647-5299
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
4301500788
MI
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
4301500788
MI
Other
Enumeration date
10/18/2012
Last updated
11/04/2019
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