Provider Demographics
NPI:1023463817
Name:ELZANIE, ASHRAF (MD)
Entity type:Individual
Prefix:
First Name:ASHRAF
Middle Name:
Last Name:ELZANIE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1080 KIRTS BLVD STE 700
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-4853
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1080 KIRTS BLVD STE 700
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-4853
Practice Address - Country:US
Practice Address - Phone:248-362-2300
Practice Address - Fax:248-362-5272
Is Sole Proprietor?:No
Enumeration Date:2016-04-28
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43015110062086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery