Provider Demographics
NPI:1255398764
Name:MAJID, OMAR A (MD)
Entity type:Individual
Prefix:DR
First Name:OMAR
Middle Name:A
Last Name:MAJID
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 33016
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48303-3016
Mailing Address - Country:US
Mailing Address - Phone:313-593-7338
Mailing Address - Fax:313-593-8844
Practice Address - Street 1:18101 OAKWOOD BLVD
Practice Address - Street 2:RADIATION ONCOLOGY DEPT
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-4089
Practice Address - Country:US
Practice Address - Phone:313-593-7338
Practice Address - Fax:313-593-8844
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301047912174400000X, 2085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIOM047912OtherBCN
MIA78604OtherALLIANCE HEALTH/LIFE INS
MIA78604OtherHEALTH ALLIANCE PLAN
MIOM047912OtherBCBS
MIP00612655OtherMEDICARE RAILROAD
MIA78604OtherALLIANCE HEALTH/LIFE INS
MIN11820006Medicare PIN