SOUTH SHORE OMS PC; NPI #1861122871

Contact Information

SOUTH SHORE OMS PC

19249 ALLEN RD
BROWNSTOWN TOWNSHIP, MI 48183-1189

Phone: 734-479-2990
Fax: 734-479-2991
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Oral and Maxillofacial Surgery	261QS0112X

Indicates primary specialty

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NPI Profile & details for SOUTH SHORE OMS PC

NPI Number	`1861122871`
LBN Legal business name	SOUTH SHORE OMS PC
Authorized official	KELLY DOHERTY - (ADMINISTRATIVE)
Entity	Organization
Organization subpart ¹	No
Enumeration date	06/13/2022
Last updated	06/13/2022 - About 4 years ago
Identifiers	n/a

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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