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General NPI Number Information
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NPI Number | 1811162928
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Entity Type | Organization
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Legal Business Name | HANNA OBERTYNSKI M D P C
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Dates
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Enumeration Date | 04/29/2008
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Last Update Date | 01/26/2011
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Provider Practice Location Address
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Address Line | 2891 E MAPLE RD STE#200
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City | TROY
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State | MI
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Zip | 48083-6106
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Country | US
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Telephone | 248-524-4000
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Fax | 248-524-0077
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Provider Business Mailing Address
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Address Line | 2891 E MAPLE RD STE#200
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City | TROY
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State | MI
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Zip | 48083-6106
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Country | US
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Telephone | 248-524-4000
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Fax | 248-524-0077
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. HANNA J OBERTYNSKI
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Credential | M.D.
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Telephone | 248-524-4000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 4301030536
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License Number State | MI
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