Individual
ELIE MOUSSALLEM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
200 PATEWOOD DR STE B260, GREENVILLE, SC 29615-6328
(864) 454-2852
(864) 454-2899
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8617
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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