Individual
JULIE ELIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2680 W CENTRE AVE, PORTAGE, MI 49024-4828
(269) 324-2400
(269) 324-0450
Mailing address
2680 W CENTRE AVE, PORTAGE, MI 49024-4828
(269) 324-2400
(269) 324-0450
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
4301088858
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0C910950
BCBSM
MI
05
—
1215078142
—
MI
05
—
4949250
—
MI
Enumeration date
02/12/2007
Last updated
11/27/2023
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