Provider Demographics
NPI:1528107547
Name:ELIA, GABRIEL (MD)
Entity type:Individual
Prefix:
First Name:GABRIEL
Middle Name:
Last Name:ELIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 13008
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48901-3008
Mailing Address - Country:US
Mailing Address - Phone:517-253-6320
Mailing Address - Fax:517-253-6321
Practice Address - Street 1:1200 E MICHIGAN AVE STE 700
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-1837
Practice Address - Country:US
Practice Address - Phone:386-364-5550
Practice Address - Fax:517-364-5549
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301095830207RN0300X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1063002OtherMCLAREN HEALTH ADVANTAGE
MIP00848492OtherMEDICARE RAILROAD
MI1103304272OtherBLUE CROSS BLUE SHIELD OF MICHIGAN/BLUE CARE NETWORK
MI200000024946OtherPHYSICIANS HEALTH PLAN-COMMERCIAL
MI1103304272OtherBLUE CARE NETWORK
MI200000024946OtherPHYSICIANS HEALTH PLAN-MEDICAID
MI9421467OtherAETNA
MI1063002OtherMCLAREN HEALTH PLAN COMMERCIAL
MI1063002OtherMCLAREN HEALTH PLAN MEDICAID
MI1103304272OtherBLUE CARE NETWORK