Healthcare Provider Details

I. General information

NPI: 1871761932
Provider Name (Legal Business Name): OAKWOOD HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2008
Last Update Date: 02/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18101 OAKWOOD
DEARBORN MI
48124-4089
US

IV. Provider business mailing address

18101 OAKWOOD BLVD
DEARBORN MI
48124-4089
US

V. Phone/Fax

Practice location:
  • Phone: 313-593-7000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code284300000X
TaxonomySpecial Hospital
License Number5601003532
License Number StateMI

VIII. Authorized Official

Name: DR. CARL BERGREN
Title or Position: MEDICAL DIRECTOR OF TRAUMA TEAM
Credential: MD
Phone: 313-593-7000