Organization
ELITE FAMILY MEDICINE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FAWAZ HASSO (MEDICAL DIRECTOR)
(248) 259-1183
Entity
Organization
Contact information
Practice address
33200 DEQUINDRE RD, SUIT 200, STERLING HEIGHTS, MI 48310-5967
(586) 977-0200
(586) 977-0000
Mailing address
1512 HAMLET DR, TROY, MI 48084-5701
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
4301083265
MI
261QP2300X
Primary Care Clinic/Center
4301088431
MI
Other
Enumeration date
01/13/2015
Last updated
04/21/2015
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