| Oakland Lifestyle Medicine-pllc | |
|
36800 Woodward Ave Ste 210 Bloomfield Hills MI 48304-0917 | |
| (248) 543-3566 | |
| (248) 543-2628 |
| Full Name | Oakland Lifestyle Medicine-pllc |
|---|---|
| Speciality | General Practice |
| Location | 36800 Woodward Ave Ste 210, Bloomfield Hills, Michigan |
| Authorized Official Name and Position | Jonathan Dean (OWNER) |
| Authorized Official Contact | 2487036288 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Oakland Lifestyle Medicine-pllc 36800 Woodward Ave Ste 210 Bloomfield Hills MI 48304-0917 Ph: (248) 543-3566 | Oakland Lifestyle Medicine-pllc 36800 Woodward Ave Ste 210 Bloomfield Hills MI 48304-0917 Ph: (248) 543-3566 |
| NPI Number | 1962129544 |
|---|---|
| Provider Enumeration Date | 10/24/2022 |
| Last Update Date | 05/19/2023 |
| Medicare PECOS PAC ID | 6901275296 |
|---|---|
| Medicare Enrollment ID | O20221208000767 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962129544 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Charles M Roll |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1770756629 PECOS PAC ID: 9638147937 Enrollment ID: I20040923001160 |
| Provider Name | Christophe Dean |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1225029382 PECOS PAC ID: 0648220749 Enrollment ID: I20050128000112 |
| Provider Name | Jonathan G Dean |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1891932273 PECOS PAC ID: 2860557642 Enrollment ID: I20090211000043 |
| Provider Name | Casey Charlebois |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1942525449 PECOS PAC ID: 5597042317 Enrollment ID: I20210107001789 |
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