Provider Demographics
NPI:1912219221
Name:CENTER FOR HEMATOLOGY & ONCOLOGY CARE
Entity Type:Organization
Organization Name:CENTER FOR HEMATOLOGY & ONCOLOGY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ISHMAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:JAIYESIMI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:248-551-6991
Mailing Address - Street 1:3577 W 13 MILE RD
Mailing Address - Street 2:SUITE 404
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-6710
Mailing Address - Country:US
Mailing Address - Phone:248-551-6900
Mailing Address - Fax:248-551-6910
Practice Address - Street 1:3577 W 13 MILE RD
Practice Address - Street 2:SUITE 404
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-6710
Practice Address - Country:US
Practice Address - Phone:248-551-6900
Practice Address - Fax:248-551-6910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-02
Last Update Date:2010-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty