Healthcare Provider Details

I. General information

NPI: 1487678322
Provider Name (Legal Business Name): ELIOT J HUSARSKY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31500 TELEGRAPH RD STE 225
BINGHAM FARMS MI
48025-4315
US

IV. Provider business mailing address

31500 TELEGRAPH RD STE 225
BINGHAM FARMS MI
48025-4315
US

V. Phone/Fax

Practice location:
  • Phone: 248-552-0620
  • Fax:
Mailing address:
  • Phone: 248-552-0620
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number045727
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: