Healthcare Provider Details

I. General information

NPI: 1962653238
Provider Name (Legal Business Name): OAKLAND ANESTHESIA CARE ASSOCIATES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2008
Last Update Date: 12/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 N PERRY ST
PONTIAC MI
48342-2217
US

IV. Provider business mailing address

PO BOX 210339
AUBURN HILLS MI
48321-0339
US

V. Phone/Fax

Practice location:
  • Phone: 248-396-0171
  • Fax:
Mailing address:
  • Phone: 248-396-0171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number StateMI

VIII. Authorized Official

Name: DR. PAUL URBANOWSKI
Title or Position: PRESIDENT
Credential: D.O.
Phone: 248-396-0171