Provider Demographics
NPI:1780233627
Name:BLOOMFIELD FOOT & ANKLE SPECIALISTS PLLC
Entity type:Organization
Organization Name:BLOOMFIELD FOOT & ANKLE SPECIALISTS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:AHMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:ELHAOULI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:248-738-5550
Mailing Address - Street 1:43750 WOODWARD AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-5063
Mailing Address - Country:US
Mailing Address - Phone:248-738-5550
Mailing Address - Fax:
Practice Address - Street 1:43750 WOODWARD AVE STE 101
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-5063
Practice Address - Country:US
Practice Address - Phone:284-538-5550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-04
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty