Healthcare Provider Details

I. General information

NPI: 1902847122
Provider Name (Legal Business Name): DANIEL ELSHOLZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 HOUGHTON AVE
SAGINAW MI
48602-5303
US

IV. Provider business mailing address

1000 HOUGHTON AVE
SAGINAW MI
48602-5303
US

V. Phone/Fax

Practice location:
  • Phone: 989-583-6800
  • Fax: 989-583-6915
Mailing address:
  • Phone: 989-583-6800
  • Fax: 989-583-6915

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number4301068243
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: