Provider Demographics
NPI:1003976416
Name:OBER, MICHAEL D (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:D
Last Name:OBER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:29201 TELEGRAPH RD
Mailing Address - Street 2:SUITE #606
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034
Mailing Address - Country:US
Mailing Address - Phone:248-356-8610
Mailing Address - Fax:248-356-6473
Practice Address - Street 1:29201 TELEGRAPH RD
Practice Address - Street 2:SUITE #606
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034
Practice Address - Country:US
Practice Address - Phone:248-356-8610
Practice Address - Fax:248-356-6473
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301074191207WX0107X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
180H262240OtherBLUE CROSS-BLUE CROSS
MO074191OtherCOMMERCIAL-COMMERCIAL NUMBER
MI478697910Medicaid
MO074191OtherCHAMPUS-CHAMPUS
MO074191OtherCHAMPUS-CHAMPUS
H99762Medicare UPIN