Provider Demographics
NPI:1770871154
Name:HILAL D ELIA M.D., P.C
Entity type:Organization
Organization Name:HILAL D ELIA M.D., P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELHAM
Authorized Official - Middle Name:F
Authorized Official - Last Name:ELIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-366-3700
Mailing Address - Street 1:950 E STATE FAIR
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48203-1273
Mailing Address - Country:US
Mailing Address - Phone:313-366-3700
Mailing Address - Fax:313-366-2767
Practice Address - Street 1:950 E STATE FAIR
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48203-1273
Practice Address - Country:US
Practice Address - Phone:313-366-3700
Practice Address - Fax:313-366-2767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-19
Last Update Date:2011-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI207R00000X261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0820448Medicare PIN