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Organization

OAKWOOD AMBULATORY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LESLEY WILLBRANDT (DIRECTOR SHARED SERVICES)
(947) 522-1911
Entity
Organization

Contact information

Practice address
15777 NORTHLINE RD, SOUTHGATE, MI 48195-2385
(734) 248-8100
Mailing address
26901 BEAUMONT BLVD, SOUTHFIELD, MI 48033-3849

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1003829441
MI
Enumeration date
03/03/2010
Last updated
06/30/2022
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