Provider Demographics
NPI:1376728857
Name:OAK NEUROVASCULAR P.C.
Entity Type:Organization
Organization Name:OAK NEUROVASCULAR P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SUPERVISOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TUSHAR
Authorized Official - Middle Name:
Authorized Official - Last Name:TRIPATHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-369-3379
Mailing Address - Street 1:PO BOX 2300
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48333-2300
Mailing Address - Country:US
Mailing Address - Phone:248-320-1744
Mailing Address - Fax:
Practice Address - Street 1:24361 GREENFIELD RD
Practice Address - Street 2:SUITE 202
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-3139
Practice Address - Country:US
Practice Address - Phone:313-369-3379
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-03
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes170100000XOther Service ProvidersMedical Genetics, Ph.D. Medical GeneticsGroup - Single Specialty