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

Elite Sports & Regenerative Medicine PLLC

Organization Sports Medicine (Family Medicine) Physician · NPI 1619863933

Elite Sports & Regenerative Medicine PLLC is a Sports Medicine (Family Medicine) Physician in Dearborn, Michigan. Registered with an NPI since 2025.

In the registry since
2025
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

1022 N Telegraph Rd Ste 2
Dearborn, MI 48128-1622
Phone: (313) 764-0088
Fax: (313) 254-3586
Show map & directions

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

Specialties & licences

Sports Medicine (Family Medicine) Physician (primary) Taxonomy 207QS0010X

Record details

NPI number1619863933
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mohammad Ibrahim — Manager · (313) 764-0088
Other names Elite Sports & Regenerative Medicine
NPI enumeratedJune 13, 2025
Last updated in NPPESJune 13, 2025
Certification dateJune 13, 2025
Mailing address1022 N Telegraph Rd Ste 2, Dearborn, MI 48128-1622

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