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General NPI Number Information
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NPI Number | 1003687385
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Entity Type | Organization
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Legal Business Name | ELITE ALLERGY PLLC
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Dates
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Enumeration Date | 01/15/2024
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Last Update Date | 02/15/2024
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Provider Practice Location Address
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Address Line | 575 COURT ST STE 3
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City | WEST BRANCH
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State | MI
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Zip | 48661-9387
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Country | US
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Telephone | 989-701-2159
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7415
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City | BLOOMFIELD HILLS
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State | MI
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Zip | 48302-7415
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Country | US
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Telephone | 989-701-2159
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HASSAN NASIR
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Credential | DO
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Telephone | 248-890-8711
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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