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Individual

ERIK BRIAN ELLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
26750 PROVIDENCE PKWY, STE 200, NOVI, MI 48374-1212
(866) 974-2673
(866) 939-2673
Mailing address
18444 N 25TH AVE, STE 310, PHOENIX, AZ 85023-1266
(866) 974-2673
(866) 939-2673

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
4301102107
MI
207X00000X
Orthopaedic Surgery Physician
4301102107
MI
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
Primary
4301102107
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PO1223793
MEDICARE RAILROAD
MI
Enumeration date
08/03/2008
Last updated
10/21/2014
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