| St Joseph Mercy Oakland | |
|
44405 Woodward Ave Pontiac MI 48341-5023 | |
| (248) 858-3000 | |
| Not Available |
| Full Name | St Joseph Mercy Oakland |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 44405 Woodward Ave, Pontiac, Michigan |
| Authorized Official Name and Position | Michael P Gusho (CFO) |
| Authorized Official Contact | 2316723886 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St Joseph Mercy Oakland 44405 Woodward Ave Pontiac MI 48341-5023 Ph: (248) 858-3000 | St Joseph Mercy Oakland 44405 Woodward Ave Pontiac MI 48341-5023 Ph: (248) 858-3000 |
| NPI Number | 1679501936 |
|---|---|
| Provider Enumeration Date | 06/28/2006 |
| Last Update Date | 07/01/2024 |
| Certification Date | 07/01/2024 |
| Medicare PECOS PAC ID | 7719896596 |
|---|---|
| Medicare Enrollment ID | O20070215000696 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679501936 | NPI | - | NPPES |
| 1557533 | Medicaid | MI | |
| 5172026 | Medicaid | MI | |
| 20008 | Other | MI | BLUE CROSS IP/OP SUB ABUS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | H047 (Michigan) | Primary |
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