Individual
GREGORY M OLDFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2300 HAGGERTY RD, SUITE 2000, WEST BLOOMFIELD, MI 48323-2184
(248) 624-9900
(248) 896-5450
Mailing address
20952 E 12 MILE RD, SUITE 200, ST CLAIR SHORES, MI 48081-3200
(586) 771-4820
(586) 771-6620
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
4301051913
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0991057
HEALTH PLUS
MI
01
—
126231
PRIORITY HEALTH
MI
01
—
340019049
RAILROAD MEDICARE
MI
01
—
4338197
AETNA
MI
01
—
6906739004
CIGNA
MI
01
—
F31980
HAP
MI
Enumeration date
04/19/2006
Last updated
01/30/2018
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