Elta, Grace H

Elta, Grace H is an individual health care provider with primary practice located at 1500 East Medical Center Dr 3Rd Floor Taubman Ctr Recp D, Ann Arbor MI 48109-5362. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Gastroenterology. Allopathic & Osteopathic Physicians / Gastroenterology is her primary health care specialty. Elta, Grace H can be contacted via phone (734) 647-5944.

Contact Information

Primary practice address
1500 East Medical Center Dr 3Rd Floor Taubman Ctr Recp D Ann Arbor MI 48109-5362
Phone: (734) 647-5944
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 4301044755 Michigan
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X 4301044755 Michigan

Profile Details

NPI number 1275615700
LBN Legal business name Elta, Grace H
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 20th, 2006
Last updated Mar 1st, 2012 - about 14 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 1275615700 NPPES
Michigan MEDICAID 1397251

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