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General NPI Number Information
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NPI Number | 1760489348
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Entity Type | Individual
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Provider Name | ELLEN BETH OZOLINS MD
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Gender | Female
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Dates
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Enumeration Date | 06/28/2005
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 44050 W 12 MILE RD
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City | NOVI
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State | MI
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Zip | 48377-2612
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Country | US
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Telephone | 248-735-3800
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Fax | 248-308-2155
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Provider Business Mailing Address
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Address Line | 44050 W 12 MILE RD
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City | NOVI
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State | MI
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Zip | 48377-2612
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Country | US
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Telephone | 248-735-3800
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Fax | 248-308-2155
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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 | 2082S0099X
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Taxonomy Name | Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
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License Number | EO065676
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | EO065676
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License Number State | MI
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