Provider Demographics
NPI:1447446562
Name:OAKLAND PHYSICAL MEDICINE PC
Entity type:Organization
Organization Name:OAKLAND PHYSICAL MEDICINE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALI
Authorized Official - Middle Name:
Authorized Official - Last Name:ALHIMIRI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-928-4444
Mailing Address - Street 1:15915 SOUTHFIELD RD
Mailing Address - Street 2:STE 700
Mailing Address - City:ALLEN PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48101-2512
Mailing Address - Country:US
Mailing Address - Phone:313-928-4444
Mailing Address - Fax:313-928-4445
Practice Address - Street 1:15915 SOUTHFIELD RD
Practice Address - Street 2:STE 700
Practice Address - City:ALLEN PARK
Practice Address - State:MI
Practice Address - Zip Code:48101-2512
Practice Address - Country:US
Practice Address - Phone:313-928-4444
Practice Address - Fax:313-928-4445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-21
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0N17500Medicare PIN