Provider Demographics
NPI:1376706101
Name:AYLI, ELIAS EMILE (DO)
Entity type:Individual
Prefix:
First Name:ELIAS
Middle Name:EMILE
Last Name:AYLI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3330 CUMBERLAND BLVD SE STE 200
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-5996
Mailing Address - Country:US
Mailing Address - Phone:770-951-8427
Mailing Address - Fax:770-951-2157
Practice Address - Street 1:11640 NORTHPARK DR STE 200
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-5741
Practice Address - Country:US
Practice Address - Phone:919-436-4124
Practice Address - Fax:919-439-9645
Is Sole Proprietor?:No
Enumeration Date:2008-07-02
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC2017-02073207N00000X, 207N00000X
NC201702073207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2017-02073OtherNC LICENSE