MEDICARE: OAKWOOD HEALTHCARE INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1396691960
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OAKWOOD HEALTHCARE INC

Provider Business Mailing Address
First Line	:	100 MICHIGAN ST NE
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49503-2560
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	18501 ROTUNDA DR
Second Line	:
City	:	DEARBORN
State	:	MI
Zip	:	48124-3891
Country	:	US
Telephone Number	:	313-593-7490
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	MATTHEW E COX
Credential	:
Telephone Number	:	616-486-6790

Provider Enumeration Date	:	03/06/2026
Last Update Date	:	03/06/2026

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