Provider Demographics
NPI:1669603544
Name:ELITE FAMILY HEALTH P.C.
Entity type:Organization
Organization Name:ELITE FAMILY HEALTH P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUNU
Authorized Official - Middle Name:
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-889-0900
Mailing Address - Street 1:916 E MAIN STREET
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-1533
Mailing Address - Country:US
Mailing Address - Phone:317-889-0900
Mailing Address - Fax:
Practice Address - Street 1:916 E MAIN ST
Practice Address - Street 2:SUITE 100
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-1533
Practice Address - Country:US
Practice Address - Phone:317-889-0900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-27
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01059202A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty