Healthcare Provider Details

I. General information

NPI: 1043245434
Provider Name (Legal Business Name): OAKLAND MEDICAL GROUP PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 08/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23411 JOHN R RD
HAZEL PARK MI
48030-1404
US

IV. Provider business mailing address

23411 JOHN R RD
HAZEL PARK MI
48030-1404
US

V. Phone/Fax

Practice location:
  • Phone: 248-399-8331
  • Fax: 248-399-3912
Mailing address:
  • Phone: 248-399-8331
  • Fax: 248-399-3912

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. HAROLD MARGOLIS
Title or Position: PRESIDENT
Credential: DO
Phone: 313-538-3099