Provider Demographics
NPI:1720200942
Name:OAKLAND DIGESTIVE HEALTH, LLC
Entity Type:Organization
Organization Name:OAKLAND DIGESTIVE HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KAMBIZ
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-844-2700
Mailing Address - Street 1:2700 S ROCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-4547
Mailing Address - Country:US
Mailing Address - Phone:248-844-2700
Mailing Address - Fax:248-852-0806
Practice Address - Street 1:2700 S ROCHESTER RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-4547
Practice Address - Country:US
Practice Address - Phone:248-844-2700
Practice Address - Fax:248-852-0806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301078345174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty