Healthcare Provider Details

I. General information

NPI: 1043307945
Provider Name (Legal Business Name): ROBERT MCELHANEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3865 S MACKINAC TRL
SAULT SAINTE MARIE MI
49783-9286
US

IV. Provider business mailing address

125 N LAKE ST
MANISTIQUE MI
49854-1234
US

V. Phone/Fax

Practice location:
  • Phone: 906-632-2805
  • Fax:
Mailing address:
  • Phone: 906-341-2144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberRM054137
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: