Provider Demographics
NPI:1841238904
Name:MAY, ELIZABETH J (MD, PHD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:J
Last Name:MAY
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1560 E MAPLE ROAD
Mailing Address - Street 2:SUITE 400 - CREDENTIALING DEPT
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083-1189
Mailing Address - Country:US
Mailing Address - Phone:313-745-4525
Mailing Address - Fax:248-359-8036
Practice Address - Street 1:26400 W 12 MILE RD
Practice Address - Street 2:STE 111
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-1700
Practice Address - Country:US
Practice Address - Phone:313-745-4525
Practice Address - Fax:248-359-8036
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2014-10-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301066237207R00000X, 207RG0100X
GA070279207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine