Individual
ELIAS G GENNAOUI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
14825 SOUTHFIELD RD, ALLEN PARK, MI 48101-2642
(313) 386-3930
(313) 386-0962
Mailing address
28011 HICKORY DR, FARMINGTON HILLS, MI 48331-2952
(248) 489-8177
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
4301037248
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3442150
—
MI
Enumeration date
01/25/2006
Last updated
12/18/2023
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