Individual
FADI ELIYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 WILLIAM CARLS DR STE 210, COMMERCE TOWNSHIP, MI 48382-2201
(248) 387-2733
(248) 387-2735
Mailing address
20952 E 12 MILE RD, SUITE 200, SAINT CLAIR SHORES, MI 48081-3200
(586) 771-4820
(586) 771-6620
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
4301083976
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0E06273
BCBSM
MI
01
—
CB9133
MEDICARE RAILROAD
MI
Enumeration date
05/10/2007
Last updated
01/29/2018
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