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General NPI Number Information
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NPI Number | 1649536541
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Entity Type | Organization
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Legal Business Name | OAKLAND SOUTHFIELD PHYSICIANS
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Dates
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Enumeration Date | 04/04/2012
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Last Update Date | 10/19/2022
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Provider Practice Location Address
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Address Line | 29200 NORTHWESTERN HWY SUITE 325
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City | SOUTHFIELD
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State | MI
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Zip | 48034-1013
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Country | US
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Telephone | 248-357-4048
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Fax | 248-357-2049
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Provider Business Mailing Address
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Address Line | 29200 NORTHWESTERN HWY SUITE 325
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City | SOUTHFIELD
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State | MI
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Zip | 48034-1013
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Country | US
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Telephone | 248-357-4048
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Fax | 248-357-2049
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. RODRIGO TOBAR JR.
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Credential | DO
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Telephone | 248-357-4048
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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