Provider Demographics
NPI:1528192275
Name:OAKLAND INFECTIOUS DISEASE ASSOCIATES PC
Entity Type:Organization
Organization Name:OAKLAND INFECTIOUS DISEASE ASSOCIATES PC
Other - Org Name:RULA MAHAYNI, M.D. P.C.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RULA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHAYNI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-332-4629
Mailing Address - Street 1:43700 WOODWARD AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-5060
Mailing Address - Country:US
Mailing Address - Phone:248-332-4629
Mailing Address - Fax:248-322-5490
Practice Address - Street 1:43700 WOODWARD AVE STE 103
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-5060
Practice Address - Country:US
Practice Address - Phone:248-332-4629
Practice Address - Fax:248-322-5490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301056551207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty