Provider Demographics
NPI:1689641458
Name:LINARES, OSCAR AUGUSTINE (MD)
Entity Type:Individual
Prefix:
First Name:OSCAR
Middle Name:AUGUSTINE
Last Name:LINARES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:751 S. MILITARY RD.
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124
Mailing Address - Country:US
Mailing Address - Phone:313-274-3311
Mailing Address - Fax:313-274-3587
Practice Address - Street 1:751 S. MILITARY RD.
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-2107
Practice Address - Country:US
Practice Address - Phone:313-274-3311
Practice Address - Fax:313-274-3587
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIOL045607207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MICG3568OtherRAILROAD MEDICARE GROUP#
MI110197442OtherRAILROAD MEDICARE
MI700H249500OtherBCBS PIN
MI700E811600OtherBCBS GROUP PIN
MI31032OtherHEALTH PLAN OF MICHIGAN
MI4522030Medicaid
MI700E811600OtherBCBS GROUP PIN
MI700H249500OtherBCBS PIN
MI0P03440Medicare ID - Type UnspecifiedGROUP PROVIDER NUMBER
MIP52570003Medicare PIN
MI110197442OtherRAILROAD MEDICARE
MI0P52570Medicare PIN
MIB46054Medicare UPIN
MI0M73900Medicare ID - Type UnspecifiedGROUP PROVIDER NUMBER
MI0M73900002Medicare ID - Type UnspecifiedMEDICARE MEMBER ID #