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Contact Information

PHILLIP OLIVEIRA, PHYSICIAN ASSISTANT
2799 W GRAND BLVD
DETROIT, MI48202-2608
 Phone: 313-916-2695
 Fax: 313-916-2687
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
 

Surgical

363AS0400X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for PHILLIP OLIVEIRA · (Male)

NPI Number 1316284318
Status Active
Credentials PHYSICIAN ASSISTANT
Entity Individual
Enumeration date 01/10/2013
Last updated 03/25/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • MI License # 5601006969
  • MI Medicaid 1316284318
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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