Provider Demographics
NPI:1750684221
Name:OAKLAND MOBILE MEDICAL SERVICES
Entity Type:Organization
Organization Name:OAKLAND MOBILE MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:248-357-2912
Mailing Address - Street 1:21310 INDEPENDENCE DR
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-5545
Mailing Address - Country:US
Mailing Address - Phone:248-357-2912
Mailing Address - Fax:
Practice Address - Street 1:21310 INDEPENDENCE DR
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-5545
Practice Address - Country:US
Practice Address - Phone:248-357-2912
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-06
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101007859207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0156303015OtherBLUE CROSS BLUE SHIELD OF MICHIGAN
MI1655392 11Medicaid
0156303015OtherBLUE CROSS BLUE SHIELD OF MICHIGAN
E25528Medicare UPIN