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Organization

OAKWOOD NEUROLOGY ASSOCIATES PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SURENDRA K JOLLY MD (DOCTOR)
(313) 271-8983
Entity
Organization

Contact information

Practice address
18181 OAKWOOD BLVD, SUITE 203, DEARBORN, MI 48124-5032
(313) 271-8983
(734) 721-6003
Mailing address
18181 OAKWOOD BLVD, SUITE 203, DEARBORN, MI 48124-5032
(313) 271-8983
(734) 721-6003

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
SJ055782
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0826162
BLUE CROSS
MI
05
2918602
MI
Enumeration date
06/15/2007
Last updated
07/10/2007
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