Provider Demographics
NPI:1710956222
Name:OAKLAND ORTHOPEDIC PARTNERS PC
Entity Type:Organization
Organization Name:OAKLAND ORTHOPEDIC PARTNERS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLOTTE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHMIDT
Authorized Official - Suffix:I
Authorized Official - Credentials:
Authorized Official - Phone:248-858-3841
Mailing Address - Street 1:44555 WOODWARD AVE
Mailing Address - Street 2:SUITE 407
Mailing Address - City:PONTIAC
Mailing Address - State:MI
Mailing Address - Zip Code:48341-5031
Mailing Address - Country:US
Mailing Address - Phone:248-334-0524
Mailing Address - Fax:248-858-3887
Practice Address - Street 1:44555 WOODWARD AVE
Practice Address - Street 2:SUITE 407
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48341-5031
Practice Address - Country:US
Practice Address - Phone:248-334-0524
Practice Address - Fax:248-858-3887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-16
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI200F30126OtherBLUE CROSS/BLUE SHIELD
MI5091120001Medicare NSC
MI0N69380001Medicare ID - Type Unspecified