Individual
ELIE MATTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
5851 MERCURY DR, DEARBORN, MI 48126-4161
(313) 441-0194
Mailing address
5438 HARTWELL ST, DEARBORN, MI 48126-3311
(313) 717-8209
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302411941
MI
Other
Enumeration date
08/28/2019
Last updated
08/28/2019
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