Individual
DR. IZABELLA ILYASOV
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
29150 FORD RD, GARDEN CITY, MI 48135-2848
(734) 762-3600
(734) 762-3611
Mailing address
45859 LATHUM DR, NOVI, MI 48374-3662
(248) 910-4892
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
4301060093
MI
Other
Enumeration date
01/27/2006
Last updated
07/08/2007
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