Provider Demographics
NPI:1427660489
Name:VIOLET ONKOBA DO PLLC
Entity type:Organization
Organization Name:VIOLET ONKOBA DO PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:
Authorized Official - First Name:ARLIENE
Authorized Official - Middle Name:
Authorized Official - Last Name:KOCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-403-8476
Mailing Address - Street 1:27209 LAHSER RD STE 128
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-8402
Mailing Address - Country:US
Mailing Address - Phone:248-313-2829
Mailing Address - Fax:248-988-4263
Practice Address - Street 1:27209 LAHSER RD STE 128
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-8402
Practice Address - Country:US
Practice Address - Phone:248-313-2829
Practice Address - Fax:248-988-4263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-20
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5101018299OtherSTATE LICENSE