MEDICARE: IHA OOMA PRIMARY LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	208000000X	Pediatrics Physician
2	207R00000X	Internal Medicine Physician
3	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1235711722
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IHA OOMA PRIMARY LLC

Provider Business Mailing Address
First Line	:	24 FRANK LLOYD WRIGHT DR STE J2000
Second Line	:
City	:	ANN ARBOR
State	:	MI
Zip	:	48105-9484
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1854 W AUBURN RD STE 100
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48309-3868
Country	:	US
Telephone Number	:	248-696-3170
Fax Number	:	248-696-3175

Authorized Official
Title or Position	:	PRESIDENT & CHIEF OPERATING OFFICER
Name	:	CYNTHIA A ELLIOTT
Credential	:
Telephone Number	:	734-327-0341

Provider Enumeration Date	:	04/23/2021
Last Update Date	:	03/24/2026

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Directions to “IHA OOMA PRIMARY LLC ” Practice Location

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