Organization
OAKLAND DERMATOLOGY ASSOCIATES PC
Active
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, SUITE 203, BLOOMFIELD HILLS, MI 48304-0926
(248) 647-5750
(248) 647-6008
Mailing address
36700 WOODWARD AVE, SUITE 203, BLOOMFIELD HILLS, MI 48304-0926
(248) 647-5750
(248) 647-6008
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
4301022545
MI
208200000X
Plastic Surgery Physician
4301032103
MI
332900000X
Non-Pharmacy Dispensing Site
4301022545
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2368466
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
10/04/2006
Last updated
03/13/2008
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