Elliott, Mark A

Elliott, Mark A is an individual health care provider with primary practice located at 1200 Sixth St Suite 200, Traverse City MI 49684-2369. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Elliott, Mark A can be contacted via phone (231) 935-5800.

Contact Information

Primary practice address
1200 Sixth St Suite 200 Traverse City MI 49684-2369
Fax: (231) 935-5799
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 4301048994 Michigan

Profile Details

NPI number 1184619744
LBN Legal business name Elliott, Mark A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 20th, 2005
Last updated Nov 24th, 2020 - about 4 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 1184619744 NPPES
Michigan MEDICAID 2995933

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