Provider Demographics
NPI:1598149379
Name:ELHAOULI, AHMAD TALAL (DPM)
Entity Type:Individual
Prefix:DR
First Name:AHMAD
Middle Name:TALAL
Last Name:ELHAOULI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43750 WOODWARD AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-5063
Mailing Address - Country:US
Mailing Address - Phone:248-738-5550
Mailing Address - Fax:
Practice Address - Street 1:43750 WOODWARD AVE STE 101
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-5063
Practice Address - Country:US
Practice Address - Phone:248-738-5550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-12
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901002597213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery