Provider Demographics
NPI:1548235369
Name:ELIAN, SAMIR AQEL (MD)
Entity Type:Individual
Prefix:MR
First Name:SAMIR
Middle Name:AQEL
Last Name:ELIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5336 TIMBERWOOD POINT DR
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-2266
Mailing Address - Country:US
Mailing Address - Phone:810-230-9082
Mailing Address - Fax:
Practice Address - Street 1:4455 TOWN CENTER PKWY
Practice Address - Street 2:SUITE A
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3425
Practice Address - Country:US
Practice Address - Phone:810-720-3370
Practice Address - Fax:810-720-3367
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301075121207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1010990OtherMCLAREN HEALTH ADVANTAGE
MI16457OtherM-CARE
MI5917178OtherAETNA
MI138398OtherPREFERRED CHOICE PPO
MI320112688OtherUNITED HEALTH CARE
MI320112688OtherTRICARE/HEALTH NET
MIE91688OtherHEALTH ALLIANCE PLAN
MI0998649OtherHEALTH PLUS
MI0N95010OtherMEDICARE PTAN
MI320112688OtherPPOM
MI0251107OtherBLUE CARE NETWORK
MI4618140Medicaid
MIP00164039OtherPALMETTO GBA RAILROAD
MI0602511071OtherBLUE CROSS BLUE SHIELD
MI7379343OtherCIGNA
MI4618140Medicaid