Individual
CHANDY ELLIMOOTTIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 E MEDICAL CENTER DRIVE, 2ND FLOOR TAUBMAN CENTER RECP C, ANN ARBOR, MI 48108
(734) 936-2047
Mailing address
3621 S STATE ST, 700 KMS PLACE, ANN ARBOR, MI 48108
(734) 936-2047
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
125056933
IL
208800000X
Urology Physician
Primary
4301107020
MI
Other
Enumeration date
06/22/2009
Last updated
06/24/2015
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