Healthcare Provider Details

I. General information

NPI: 1457446726
Provider Name (Legal Business Name): ST JOHN HEALTH SYSTEM OAKLAND
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27351 DEQUINDRE
MADISON HTS MI
48071
US

IV. Provider business mailing address

27351 DEQUINDRE
MADISON HTS MI
48071
US

V. Phone/Fax

Practice location:
  • Phone: 248-967-7740
  • Fax: 248-967-7299
Mailing address:
  • Phone: 248-967-7740
  • Fax: 248-967-7299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: CHARLES H FEINMAN
Title or Position: PRESIDENT
Credential: DO
Phone: 248-967-7740