| Elite Care Physicians, Pllc | |
|
27144 Joy Rd Redford MI 48239-2368 | |
| (313) 410-6003 | |
| (313) 937-1402 |
| Full Name | Elite Care Physicians, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 27144 Joy Rd, Redford, Michigan |
| Authorized Official Name and Position | Hadi A Dourra (MEDICAL DIRECTOR) |
| Authorized Official Contact | 3134106003 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elite Care Physicians, Pllc 27144 Joy Rd Redford MI 48239-2368 Ph: (313) 410-6003 | Elite Care Physicians, Pllc 27144 Joy Rd Redford MI 48239-2368 Ph: (313) 410-6003 |
| NPI Number | 1982830535 |
|---|---|
| Provider Enumeration Date | 06/09/2009 |
| Last Update Date | 07/08/2015 |
| Medicare PECOS PAC ID | 9133265945 |
|---|---|
| Medicare Enrollment ID | O20091008000410 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982830535 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Hadi A Dourra |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003975517 PECOS PAC ID: 5193823409 Enrollment ID: I20070611000500 |
| Provider Name | Stephanie Marie Bonora |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891209391 PECOS PAC ID: 2466719422 Enrollment ID: I20171129001054 |
| Provider Name | Hassan Bazzi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366939951 PECOS PAC ID: 9931508496 Enrollment ID: I20210723001206 |
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