Provider Demographics
NPI:1386008233
Name:GAIES, ELISSA (MD)
Entity Type:Individual
Prefix:DR
First Name:ELISSA
Middle Name:
Last Name:GAIES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ELISSA
Other - Middle Name:
Other - Last Name:SLOVIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2200 GREEN RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-2948
Mailing Address - Country:US
Mailing Address - Phone:734-994-7446
Mailing Address - Fax:734-623-8590
Practice Address - Street 1:2200 GREEN RD
Practice Address - Street 2:SUITE B
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105-2948
Practice Address - Country:US
Practice Address - Phone:734-994-7446
Practice Address - Fax:734-623-8590
Is Sole Proprietor?:No
Enumeration Date:2016-04-07
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301117262207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine