Healthcare Provider Details

I. General information

NPI: 1376797217
Provider Name (Legal Business Name): OAKLAND MEDICAL GROUP PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

11900 E 12 MILE RD SUITE 300
WARREN MI
48093-3400
US

IV. Provider business mailing address

11900 E 12 MILE RD SUITE 300
WARREN MI
48093-3400
US

V. Phone/Fax

Practice location:
  • Phone: 586-751-7515
  • Fax: 586-751-1302
Mailing address:
  • Phone: 586-751-7515
  • Fax: 586-751-1302

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. HAROLD MARGOLIS
Title or Position: PRESIDENT
Credential: DO
Phone: 248-851-1430