Healthcare Provider Details

I. General information

NPI: 1801164876
Provider Name (Legal Business Name): OAKLAND REHABILITATION ASSOCIATES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2011
Last Update Date: 06/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 HAGGERTY RD SUITE 2130
WEST BLOOMFIELD MI
48323-2184
US

IV. Provider business mailing address

2300 HAGGERTY RD SUITE 2130
WEST BLOOMFIELD MI
48323-2184
US

V. Phone/Fax

Practice location:
  • Phone: 248-669-2040
  • Fax:
Mailing address:
  • Phone: 248-669-2040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number5101011994
License Number StateMI

VIII. Authorized Official

Name: DR. SHELLEY ANN NEPA
Title or Position: PRESIDENT
Credential: D.O.
Phone: 248-669-2040