Healthcare Provider Details

I. General information

NPI: 1366739815
Provider Name (Legal Business Name): OAKLAND PHYSICIANS MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2011
Last Update Date: 09/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1305 N OAKLAND BLVD
WATERFORD MI
48327-1547
US

IV. Provider business mailing address

4947 RELIABLE PKWY
CHICAGO IL
60686-0049
US

V. Phone/Fax

Practice location:
  • Phone: 248-666-9000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License NumberL1825181
License Number StateMI

VIII. Authorized Official

Name: MR. DENNIS FRANKS
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 248-857-7583