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General NPI Number Information
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NPI Number | 1790715480
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Entity Type | Organization
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Legal Business Name | YEHIA I ELSAFY M D P L C
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 11/10/2009
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Provider Practice Location Address
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Address Line | 2425 MILITARY ST BUILDING #1
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City | PORT HURON
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State | MI
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Zip | 48060-6692
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Country | US
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Telephone | 810-985-6680
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Fax | 810-985-6809
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Provider Business Mailing Address
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Address Line | 4296 GRATIOT AVE
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City | PORT HURON
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State | MI
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Zip | 48060-1599
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Country | US
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Telephone | 810-985-6680
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Fax | 810-985-6809
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Authorized Official
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Title or Position | OWNER
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Name | DR. YEHIA IBRAHAM ELSAFY
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Credential | M.D.
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Telephone | 810-985-6680
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 4301045260
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License Number State | MI
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