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Individual

ELAINA DICLEMENTE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.A.-C

Contact information

Practice address
44199 DEQUINDRE RD STE 222, TROY, MI 48085-1128
(248) 879-5570
Mailing address
748 ROXBURY CT, OXFORD, MI 48371-1563
(248) 520-0608

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601007990
MI

Other

Enumeration date
10/08/2016
Last updated
06/21/2019
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