Individual
JACOB OBLAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
22101 MOROSS RD, DETROIT, MI 48236-2148
(313) 343-3400
(313) 343-4056
Mailing address
22101 MOROSS RD, DETROIT, MI 48236-2148
(313) 343-3400
(313) 343-4056
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4301507128
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1033670724
—
MI
Enumeration date
03/26/2019
Last updated
05/28/2022
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