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General NPI Number Information
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NPI Number | 1811214489
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Entity Type | Organization
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Legal Business Name | HALO MEDICAL GROUP PLLC
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Dates
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Enumeration Date | 04/22/2010
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Last Update Date | 07/27/2018
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Provider Practice Location Address
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Address Line | 4160 JOHN R ST STE 510
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City | DETROIT
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State | MI
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Zip | 48201
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Country | US
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Telephone | 313-993-7777
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Fax | 313-993-2563
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Provider Business Mailing Address
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Address Line | 22720 MICHIGAN AVE STE 200
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City | DEARBORN
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State | MI
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Zip | 48124-2021
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Country | US
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Telephone | 313-791-3000
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Fax | 313-791-2800
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MAHIR D ELDER
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Credential | M.D.
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Telephone | 313-993-7777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology 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 | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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