Provider Demographics
NPI:1275156994
Name:NEUROSURGICAL SERVICES OF OAKLAND
Entity Type:Organization
Organization Name:NEUROSURGICAL SERVICES OF OAKLAND
Other - Org Name:NEUROSURGICAL SERVICES OF OAKLAND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:CROISSANT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:586-489-3639
Mailing Address - Street 1:44555 WOODWARD AVE STE 307
Mailing Address - Street 2:
Mailing Address - City:PONTIAC
Mailing Address - State:MI
Mailing Address - Zip Code:48341-5035
Mailing Address - Country:US
Mailing Address - Phone:248-484-5303
Mailing Address - Fax:248-858-5869
Practice Address - Street 1:44555 WOODWARD AVE STE 307
Practice Address - Street 2:
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48341-5035
Practice Address - Country:US
Practice Address - Phone:248-484-5303
Practice Address - Fax:248-858-5869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-28
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty