Healthcare Provider Details

I. General information

NPI: 1023406188
Provider Name (Legal Business Name): ELITE HEALTH, PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/24/2014
Last Update Date: 12/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 FULTON ST E SUITE A
GRAND RAPIDS MI
49503-4302
US

IV. Provider business mailing address

310 FULTON ST E SUITE A
GRAND RAPIDS MI
49503-4302
US

V. Phone/Fax

Practice location:
  • Phone: 616-644-1423
  • Fax: 616-773-1291
Mailing address:
  • Phone: 616-644-1423
  • Fax: 616-773-1291

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number4301089694
License Number StateMI

VIII. Authorized Official

Name: DR. NAVEED NAEEM
Title or Position: PRESIDENT
Credential: MD
Phone: 616-644-1416