Elnick, Mary Jo
Elnick, Mary Jo is an individual health care provider with primary practice located at 22250 Providence Dr Ste 304, Southfield MI 48075. She recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as her primary health care specialty. Elnick, Mary Jo can be contacted via phone (248) 569-4366.Contact Information
Primary practice address
22250 Providence Dr Ste 304
Southfield MI 48075
Phone: (248) 569-4366
Fax: (248) 569-4614
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | ME404005 | Michigan |
Profile Details
| NPI number | 1164404471 |
|---|---|
| LBN Legal business name | Elnick, Mary Jo |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 14th, 2005 |
| Last updated | Jul 8th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164404471 | NPPES |
| Michigan | MEDICAID | 10275190 |
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