Organization
ELIAS CARDIOVASCULAR DISEASE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIAS SOLOMON M.D (CEO)
(855) 541-2862
Entity
Organization
Contact information
Practice address
1104 E STATE HIGHWAY 152 UNIT 2, MUSTANG, OK 73064-5116
(855) 541-2862
(405) 716-4808
Mailing address
1104 E STATE HIGHWAY 152 UNIT 2, MUSTANG, OK 73064-5116
(855) 541-2862
(405) 716-4808
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
24555
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24555
MEDICAL LICENSE
OK
Enumeration date
12/02/2016
Last updated
12/02/2016
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