Healthcare Provider Details
I. General information
NPI: 1104044783
Provider Name (Legal Business Name): SOUTHFIELD OBSTETRICAL SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/22/2007
Last Update Date: 09/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
30400 TELEGRAPH RD SUITE 350
BINGHAM FARMS MI
48025-5814
US
IV. Provider business mailing address
30400 TELEGRAPH RD SUITE 350
BINGHAM FARMS MI
48025-5814
US
V. Phone/Fax
- Phone: 248-353-9460
- Fax: 248-353-8084
- Phone: 248-353-9460
- Fax: 248-353-8084
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VH0002X |
| Taxonomy | Hospice and Palliative Medicine (Obstetrics & Gynecology) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
LEON
HOCHMAN
Title or Position: PRESIDENT
Credential: MD
Phone: 248-353-9460