Doctor Name: | DR. ELIAS G GENNAOUI |
NPI Number: | 1316917917 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 37248 |
Business Practice Address: | 14825 Southfield Rd Allen Park, MI - 481012642 |
Business Phone Number: | 3133863930 |
Business Fax Number: | 3133860962 |
Mailing Address: | 28011 Hickory Dr, FARMINGTON HILLS |
State: | MI |
Postal Code: | 483312952 |
Phone Number: | 2484898177 |
Fax Number: | |
NPI Enumeration Date: | 01/25/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 37248 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |