Provider Demographics
NPI:1568660876
Name:OAKLAND MEDICAL GROUP PC
Entity Type:Organization
Organization Name:OAKLAND MEDICAL GROUP PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:
Authorized Official - Last Name:MARGOLIS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:248-399-4400
Mailing Address - Street 1:27301 DEQUINDRE RD
Mailing Address - Street 2:SUITE 314
Mailing Address - City:MADISON HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48071-3473
Mailing Address - Country:US
Mailing Address - Phone:248-399-4400
Mailing Address - Fax:248-399-4840
Practice Address - Street 1:3577 W 13 MILE RD
Practice Address - Street 2:SUITE 204
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-6710
Practice Address - Country:US
Practice Address - Phone:248-551-2446
Practice Address - Fax:248-551-1094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-08
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4123040001Medicare NSC