Organization
SOUTH OAKLAND GASTROENTEROLOGY ASSOCIATES PC
Active
Organization
SOUTH OAKLAND GASTROENTEROLOGY ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOLIAN SAM KATHAWA (MANAGING MEMBER)
(248) 579-9220
Entity
Organization
Contact information
Practice address
23133 ORCHARD LAKE RD STE 200, FARMINGTON, MI 48336-3279
(248) 579-9220
(248) 426-7350
Mailing address
PO BOX 72737, CLEVELAND, OH 44192-0002
(248) 579-9220
(248) 426-7350
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
5101006198
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316919616
—
MI
Enumeration date
02/02/2006
Last updated
10/28/2025
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