Provider Demographics
NPI:1891973343
Name:OAKWOOD GROUP IX, LLC
Entity Type:Organization
Organization Name:OAKWOOD GROUP IX, LLC
Other - Org Name:OAKWOOD NEUROSCIENCE CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:CHEIF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:MALY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-791-4700
Mailing Address - Street 1:18101 OAKWOOD BLVD
Mailing Address - Street 2:SUITE 411
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-4089
Mailing Address - Country:US
Mailing Address - Phone:313-982-5290
Mailing Address - Fax:
Practice Address - Street 1:18101 OAKWOOD BLVD
Practice Address - Street 2:SUITE 411
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-4089
Practice Address - Country:US
Practice Address - Phone:313-982-5290
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-07
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty