Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 0102202203 | VA |
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 5101015546 | MI |
NPI | 1255505723 |
---|---|
Provider Name | Dr. Eddie F El-Yussif |
First Address | Clinton Township, MI 48038-6333 |
Second Address | Clinton Township, MI 48038-6333 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2008 |
Last Update Date | 01/10/2012 |