Doctor Name: | REBECCA ROSE ELZINGA |
NPI Number: | 1760617518 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DPM |
License Number: | |
Business Practice Address: | 24445 Northwestern Hwy Suite 206 Southfield, MI - 480756501 |
Business Phone Number: | 2487990086 |
Business Fax Number: | 2483501178 |
Mailing Address: | 24445 Northwestern Hwy, Suite 206 SOUTHFIELD |
State: | MI |
Postal Code: | 480756501 |
Phone Number: | 2487990086 |
Fax Number: | 2483501178 |
NPI Enumeration Date: | 05/22/2009 |
NPI Last Update Date: | 09/28/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | AZ |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |