Individual
DR. ELLEN K ATHENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
15100 S PLAZA DR, TAYLOR, MI 48180-5203
(734) 287-3700
(734) 287-1859
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849
(947) 522-1863
(947) 522-0307
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
EA007598
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1323893
—
MI
Enumeration date
04/03/2006
Last updated
10/22/2020
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