Provider Demographics
NPI:1184799736
Name:OAKLAND PSYCHIATRIC ASSOCIATES PC
Entity type:Organization
Organization Name:OAKLAND PSYCHIATRIC ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MONDROW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-682-0741
Mailing Address - Street 1:43700 WOODWARD AVE STE 301
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-5062
Mailing Address - Country:US
Mailing Address - Phone:248-335-4010
Mailing Address - Fax:248-858-3874
Practice Address - Street 1:43700 WOODWARD AVE STE 301
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-5062
Practice Address - Country:US
Practice Address - Phone:248-335-4010
Practice Address - Fax:248-977-3860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2084P0800X
MINJ0427632084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI260F377910OtherBCBS
MI=========OtherTAX ID