Healthcare Provider Details

I. General information

NPI: 1508051533
Provider Name (Legal Business Name): ASSOCIATES IN RADIATION ONCOLOGY, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2007
Last Update Date: 04/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18101 OAKWOOD BLVD RADIATION ONCOLOGY DEPARTMENT
DEARBORN MI
48124-4089
US

IV. Provider business mailing address

1997 MEADOW CT
BLOOMFIELD HILLS MI
48302-1242
US

V. Phone/Fax

Practice location:
  • Phone: 313-593-5852
  • Fax: 313-436-2820
Mailing address:
  • Phone: 313-436-2208
  • Fax: 313-436-2820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. OMAR MAURICIO SALAZAR
Title or Position: PRESIDENT
Credential: MD
Phone: 313-593-5852