Individual
ELIE MOUSSALLEM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
81527
SC
2086S0129X
Vascular Surgery Physician
81527
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/18/2015
Last updated
11/03/2025
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