| 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 |
| Certification 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 | (NU) | 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 | Khalid Sabah Zakaria |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033101084 PECOS PAC ID: 6305808411 Enrollment ID: I20041101000843 |
| 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 | Ahmad M Yasin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598007510 PECOS PAC ID: 4587973318 Enrollment ID: I20160428000992 |
| 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 |
| Provider Name | Kyle Zakkar |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1083104525 PECOS PAC ID: 7517400351 Enrollment ID: I20250911000269 |
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