Organization
OAKLAND DERMATOLOGY ASSOCIATES
Active
Other names
NELDAGAE S CHISA MD
Organization subpart
No
Provider details
NPI number
Authorized official
NELDAGAE CHISA (PRESIDENT OWNER)
(248) 647-5015
Entity
Organization
Contact information
Practice address
36700 WOODWARD AVE, BLOOMFIELD HILLS, MI 48304-0926
(248) 647-5750
(248) 647-6008
Mailing address
36700 WOODWARD AVE, BLOOMFIELD HILLS, MI 48304-0926
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
4301022545
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2368466
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
08/10/2006
Last updated
08/22/2020
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