| Elite Medical Group Pc | |
| 
					3210 Pine Lake Rd West Bloomfield MI 48324-1951  | |
| (248) 974-2511 | |
| Not Available | 
| Full Name | Elite Medical Group Pc | 
|---|---|
| Speciality | Internal Medicine | 
| Location | 3210 Pine Lake Rd, West Bloomfield, Michigan | 
| Authorized Official Name and Position | Yousif Ishmail (OWNER) | 
| Authorized Official Contact | 2489742511 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Elite Medical Group Pc 3210 Pine Lake Rd West Bloomfield MI 48324-1951 Ph: (248) 974-2511  | Elite Medical Group Pc 3210 Pine Lake Rd West Bloomfield MI 48324-1951 Ph: (248) 974-2511  | 
| NPI Number | 1801637293 | 
|---|---|
| Provider Enumeration Date | 06/01/2024 | 
| Last Update Date | 06/01/2024 | 
| Medicare PECOS PAC ID | 1759813629 | 
|---|---|
| Medicare Enrollment ID | O20241016003227 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1801637293 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary | 
| Provider Name | Remi O Soile | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1366510893 PECOS PAC ID: 4880590355 Enrollment ID: I20031210000094  | 
| Provider Name | Shaileshkumar K Desai | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1225046220 PECOS PAC ID: 9638132251 Enrollment ID: I20041112000711  | 
| Provider Name | Yousif T Ismail | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1306078662 PECOS PAC ID: 3870729080 Enrollment ID: I20131118001518  | 
| Provider Name | Aiman Mahmood | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1003170739 PECOS PAC ID: 1850609553 Enrollment ID: I20151029000721  | 
| Provider Name | Rose Natheer | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1184030942 PECOS PAC ID: 8123394764 Enrollment ID: I20171025002979  | 
| Provider Name | Ammar W Alkhafaji | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1164047932 PECOS PAC ID: 2668895962 Enrollment ID: I20240110002634  | 
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