Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Elite Provider Group PC

Organization Family Medicine Physician · NPI 1093602229

Elite Provider Group PC is a Family Medicine Physician in Clarkston, Michigan. Registered with an NPI since 2025.

In the registry since
2025
Specialties on file
3
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

5900 Waldon Rd Ste A
Clarkston, MI 48346-4806
Phone: (248) 625-7890
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X
Internal Medicine Physician Taxonomy 207R00000X
Pediatrics Physician Taxonomy 208000000X

Record details

NPI number1093602229
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Crystal Chandler — Authorized Official · (810) 424-2136
NPI enumeratedJune 20, 2025
Last updated in NPPESSeptember 4, 2025
Certification dateSeptember 4, 2025
Mailing address3495 S Center Rd, Burton, MI 48519-1455

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