Healthcare Provider Details
I. General information
NPI: 1821310806
Provider Name (Legal Business Name): OAKWOOD HEALTHCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/18/2010
Last Update Date: 05/01/2025
Certification Date: 05/01/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
18100 OAKWOOD BLVD
DEARBORN MI
48124-4085
US
IV. Provider business mailing address
26901 BEAUMONT BLVD BLDG D6
SOUTHFIELD MI
48033-3849
US
V. Phone/Fax
- Phone: 313-438-7969
- Fax: 313-438-7960
- Phone: 947-522-1963
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QE0700X |
| Taxonomy | End-Stage Renal Disease (ESRD) Treatment Clinic/Center |
| License Number | 820120 |
| License Number State | MI |
VIII. Authorized Official
Name:
MATTHEW
E
COX
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 947-522-3333