| Elite Family Medicine Pllc | |
|
33200 Dequindre Rd Suit 200 Sterling Heights MI 48310-5967 | |
| (586) 977-0200 | |
| (586) 977-0000 |
| Full Name | Elite Family Medicine Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 33200 Dequindre Rd, Sterling Heights, Michigan |
| Authorized Official Name and Position | Fawaz Hasso (MEDICAL DIRECTOR) |
| Authorized Official Contact | 2482591183 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elite Family Medicine Pllc 1512 Hamlet Dr Troy MI 48084-5701 Ph: () - | Elite Family Medicine Pllc 33200 Dequindre Rd Suit 200 Sterling Heights MI 48310-5967 Ph: (586) 977-0200 |
| NPI Number | 1699164699 |
|---|---|
| Provider Enumeration Date | 01/13/2015 |
| Last Update Date | 04/21/2015 |
| Medicare PECOS PAC ID | 5890015192 |
|---|---|
| Medicare Enrollment ID | O20150528001482 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699164699 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 4301083265 (Michigan) | Primary |
| 261QP2300X | Clinic/center - Primary Care | 4301088431 (Michigan) | Secondary |
| Provider Name | Fawaz M Hasso |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972647196 PECOS PAC ID: 7719086800 Enrollment ID: I20070702000339 |
| Provider Name | Maha G Hasso |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043426695 PECOS PAC ID: 8123170818 Enrollment ID: I20090709000689 |
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