El Tal MD PC

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

4301089516 Issued in MI

Legal business name

EL TAL MD PC

Practice address

555 Midtowne St NE Ste 301
Grand Rapids, MI 49503-5729

Phone

(616) 248-8864

Fax

(616) 248-8874

NPI assigned

Jul 13, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Abdel K El Tal, MD

Title

President

Phone

(313) 312-9050

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1436745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436745600000",
    "number": "1003290750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24330 ANN ARBOR TRL",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481271708",
            "telephone_number": "313-312-9050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 MIDTOWNE ST NE STE 301",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495035729",
            "telephone_number": "616-248-8864",
            "fax_number": "616-248-8874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EL TAL MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-13",
        "last_updated": "2015-07-13",
        "status": "A",
        "authorized_official_last_name": "EL TAL",
        "authorized_official_first_name": "ABDEL",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "313-312-9050",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "MI",
            "license": "4301089516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Chiamaka Ekeagwu
• Tiana Ekhande, D.O
• Aaron Ronald Ekins
• Jennifer J Ekkens, DO
• Mohamad El Shami, MD
• Mohamad Ahmad El-Kurdi, MD
• Ibrahim El-Magharbel, M.D.
• Mohammed El-Shareif, D.D.S.
• Elahl Counseling and Consultation Services, PLC
• Cherie Nicholle Elahl, LMSW

• MOHS-Micrographic Surgery Physician in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• MOHS-Micrographic Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.