MEDICARE: DR. EDWARD OXER PH.D./LICENSED PSYCH

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
1	103T00000X	Psychologist	6301002804	MI

General Provider Information

NPI Number	:	1386600971
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDWARD OXER PH.D./LICENSED PSYCH

Provider Business Mailing Address
First Line	:	1968 WINCHESTER DR
Second Line	:
City	:	EAST LANSING
State	:	MI
Zip	:	48823-1355
Country	:	US
Telephone Number	:	517-337-1222
Fax Number	:

Provider Business Practice Location Address
First Line	:	1968 WINCHESTER DR
Second Line	:
City	:	EAST LANSING
State	:	MI
Zip	:	48823-1355
Country	:	US
Telephone Number	:	517-337-1222
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/24/2006
Last Update Date	:	11/28/2007

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