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Individual

VINCENT R ELIE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
211 E MIDDLE ST, CHELSEA, MI 48118-1034
(734) 417-7054
Mailing address
211 E MIDDLE ST, CHELSEA, MI 48118-1034
(734) 417-7054

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
VE057786
MI
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
VE057786
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
108123621
BCBSM
MI
05
4284888
MI
01
ON 26970
MEDICARE IDENTIFICATION NUMBER
MI
01
VE057786
MEDICAL LICENSE
MI
Enumeration date
07/09/2006
Last updated
06/17/2011
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