Individual
ELLIOTT S ATTISHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
32100 TELEGRAPH RD, SUITE 110, BINGHAM FARMS, MI 48025-2452
(248) 644-1221
(248) 644-2748
Mailing address
32100 TELEGRAPH RD, SUITE 110, BINGHAM FARMS, MI 48025-2452
(248) 644-1221
(248) 644-2748
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
5101013649
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
433451311
—
MI
Enumeration date
06/02/2005
Last updated
04/30/2009
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