Physician Compare National (NPI:1326124090)

HEALTHCARE PROVIDER: BAHRAM ELAMI M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1326124090
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3072684323
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080616000012
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	ELAMI
	Individual professional last name
Provider First Name	BAHRAM
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF VERMONT COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	1992
	Individual professional's medical school graduation year
Primary Specialty	GENERAL PRACTICE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	GERIATRIC MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	GERIATRIC MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	5084 LOVERS LN
	Group Practice or individual's line 1 address
City	PORTAGE
	Group Practice or individual's city
State	MI
	Group Practice or individual's state
Zip Code	490021557
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	230117
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	BORGESS MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	230017
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	BRONSON METHODIST HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	231328
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	ALLEGAN GENERAL HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	230085
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	BRONSON SOUTH HAVEN HOSPITAL
	Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5	230236
	Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5	METRO HEALTH HOSPITAL
	Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment	Y

Physician Compare National (NPI:1326124090)

HEALTHCARE PROVIDER: BAHRAM ELAMI M.D.

Individual Professional Information

Medical School Information

Practice Information

Hospital(s) Affiliation Information