Healthcare Provider Details

I. General information

NPI: 1578228300
Provider Name (Legal Business Name): ELITE HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2021
Last Update Date: 07/30/2024
Certification Date: 10/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5895 W VERNOR HWY
DETROIT MI
48209-2159
US

IV. Provider business mailing address

5895 W VERNOR HWY
DETROIT MI
48209-2159
US

V. Phone/Fax

Practice location:
  • Phone: 313-554-4357
  • Fax: 313-554-1565
Mailing address:
  • Phone: 313-554-4357
  • Fax: 313-554-1565

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JAMAL M AOUN
Title or Position: OWNER/DO
Credential: DO
Phone: 313-618-1010