Provider Demographics
NPI:1104044783
Name:SOUTHFIELD OBSTETRICAL SERVICES PC
Entity Type:Organization
Organization Name:SOUTHFIELD OBSTETRICAL SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LEON
Authorized Official - Middle Name:
Authorized Official - Last Name:HOCHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-353-9460
Mailing Address - Street 1:30400 TELEGRAPH RD
Mailing Address - Street 2:SUITE 350
Mailing Address - City:BINGHAM FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48025-5814
Mailing Address - Country:US
Mailing Address - Phone:248-353-9460
Mailing Address - Fax:248-353-8084
Practice Address - Street 1:30400 TELEGRAPH RD
Practice Address - Street 2:SUITE 350
Practice Address - City:BINGHAM FARMS
Practice Address - State:MI
Practice Address - Zip Code:48025-5814
Practice Address - Country:US
Practice Address - Phone:248-353-9460
Practice Address - Fax:248-353-8084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-22
Last Update Date:2009-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VH0002XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyHospice and Palliative MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0F376930OtherMEDICARE PLUS BLUE
MI1329663Medicaid
MI1790780864OtherBLUE CARE NETWORK
MI160F376930OtherBCBS OF MI FEDERAL EMPLOY
MI4461641Medicaid
MI160F376930OtherBCBS OF MICHIGAN
MI4461632Medicaid
MI4620480Medicaid
MI160F376930OtherBLUE CARE NETWORK
MI9041407Medicaid
MI4461641Medicaid
MI4461641Medicaid
MI4620480Medicaid
MI=========OtherCOMMERICAL INSURANCES
MI160F376930OtherBLUE CARE NETWORK