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General NPI Number Information
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NPI Number | 1407351737
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Entity Type | Individual
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Provider Name | ELISABETH EKKEL-AYOUB DO
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Gender | Female
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Dates
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Enumeration Date | 03/28/2018
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Last Update Date | 11/14/2024
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Provider Practice Location Address
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Address Line | COMPREHENSIVE BREAST CARE 4967 CROOKS RD #210
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City | TROY
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State | MI
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Zip | 48098
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Country | US
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Telephone | 248-687-7300
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Fax | 248-687-7305
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Provider Business Mailing Address
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Address Line | COMPREHENSIVE BREAST CARE 5701 BOW POINTE DR., SUITE 280
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City | CLARKSTON
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State | MI
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Zip | 48346
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Country | US
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Telephone | 248-922-6635
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Fax | 248-922-6636
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086X0206X
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Taxonomy Name | Surgical Oncology Physician
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License Number | 5101027297
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 5101027297
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License Number State | MI
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