Individual
ELIZABETH ANNE BANKSTAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
22201 MOROSS RD, PROFESSIONAL BUILDING II, SUITE 50, GROSSE POINTE, MI 48236-2169
(313) 343-7774
Mailing address
20400 WALLACE ST, ROSEVILLE, MI 48066-1754
(586) 294-2542
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301092550
MI
Other
Enumeration date
03/02/2009
Last updated
03/02/2009
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