Healthcare Provider Details

I. General information

NPI: 1487803953
Provider Name (Legal Business Name): OAKLAND PHYSICIANS MEDICAL CENTER, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2008
Last Update Date: 11/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

461 W HURON ST
PONTIAC MI
48341-1601
US

IV. Provider business mailing address

461 W HURON ST SUITE 206
PONTIAC MI
48341-1601
US

V. Phone/Fax

Practice location:
  • Phone: 248-857-7583
  • Fax:
Mailing address:
  • Phone: 248-857-7583
  • Fax: 248-857-7588

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ANIL B KUMAR
Title or Position: CEO
Credential: MD
Phone: 248-857-7583