Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 2964349 | MI |
Y | 207QG0300X | Family Doctor - Geriatric Medicine | 2964349 | MI |
NPI | 1346510203 |
---|---|
Provider Name | Robert Willis Oakes |
First Address | Harbor Beach, MI 48441-0130 |
Second Address | Harbor Beach, MI 48441-1370 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2012 |
Last Update Date | 10/01/2012 |