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NPI Code Detail

MEDICARE: OAKLAND MEDICAL GROUP PC

MEDICARE: OAKLAND MEDICAL GROUP PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RG0100XGastroenterology Physician
2207R00000XInternal Medicine Physician

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1DA8060OTHERMIMEDICARE ID TYPE UNSPECIFIED

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2700F310000OTHERMIBLUE SHIELD GROUP

General Provider Information

NPI Number : 1043245434
Entity Type Code : Organization
Provider Name (Legal Business Name) : OAKLAND MEDICAL GROUP PC
Provider Business Mailing Address
First Line : 23411 JOHN R RD
Second Line :
City : HAZEL PARK
State : MI
Zip : 48030-1404
Country : US
Telephone Number : 248-399-8331
Fax Number : 248-399-3912
Provider Business Practice Location Address
First Line : 23411 JOHN R RD
Second Line :
City : HAZEL PARK
State : MI
Zip : 48030-1404
Country : US
Telephone Number : 248-399-8331
Fax Number : 248-399-3912
Authorized Official
Title or Position : PRESIDENT
Name : DR. HAROLD MARGOLIS
Credential : DO
Telephone Number : 313-538-3099
Provider Enumeration Date : 07/12/2006
Last Update Date : 08/19/2008

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Directions to “OAKLAND MEDICAL GROUP PC ” Practice Location

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