NPI 1003290750

El Tal MD PC

Organisation MOHS-Micrographic Surgery Physician Grand Rapids, MI

Practice location

Address: 555 Midtowne St NE STE 301, Grand Rapids, MI 49503-5729
Phone: (616) 248-8864
Fax: (616) 248-8874
Mailing address: 24330 Ann Arbor Trl, Dearborn Heights, MI 48127-1708

Authorised official

Name: Abdel K El Tal
Title: President
Phone: (313) 312-9050

Registered specialties

MOHS-Micrographic Surgery Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207ND0101X Licence 4301089516 (MI)

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Registry record

NPI: 1003290750
Entity type: Organization
NPI issued: 13 Jul 2015
Record last updated: 13 Jul 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.