Elconin, Lisa B.

Elconin, Lisa B. is an individual health care provider with primary practice located at 5777 W Maple Rd Suite 140, West Bloomfield MI 48322-2267. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Elconin, Lisa B. can be contacted via phone (248) 406-1000.

Contact Information

Primary practice address
5777 W Maple Rd Suite 140 West Bloomfield MI 48322-2267
Phone: (248) 406-1000
Fax: (248) 406-1001
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 4301060119 Michigan

Profile Details

NPI number 1124095880
LBN Legal business name Elconin, Lisa B.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 1st, 2006
Last updated Aug 5th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124095880 NPPES
Michigan MEDICAID 4619246

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