Poulos, Elijah Michael
Poulos, Elijah Michael is an individual health care provider with primary practice located at 1360 N Rim Dr , Flagstaff AZ 86001-3111. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease, Allopathic & Osteopathic Physicians / Critical Care Medicine. Allopathic & Osteopathic Physicians / Critical Care Medicine is his primary health care specialty. Poulos, Elijah Michael can be contacted via phone (928) 774-8000.Contact Information
Primary practice address
1360 N Rim Dr
Flagstaff AZ 86001-3111
Phone: (928) 774-8000
Fax: (928) 774-0372
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | R71506 | Arizona |
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | 46193 | Arizona |
| Allopathic & Osteopathic Physicians / Critical Care Medicine | 207RC0200X | 46193 | Arizona |
Profile Details
| NPI number | 1386871325 |
|---|---|
| LBN Legal business name | Poulos, Elijah Michael |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 17th, 2009 |
| Last updated | Jun 18th, 2024 - about 6 months 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 | 1386871325 | NPPES |
| Arizona | MEDICAID | 026439 |
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