Olive Tree Medical Clinic PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

OLIVE TREE MEDICAL CLINIC PC

Practice address

18181 Oakwood Blvd
Suite 206
Dearborn, MI 48124-5032

Phone

(313) 451-8253

Fax

(313) 451-8351

NPI assigned

Oct 5, 2010

Last updated

Nov 2, 2016By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Sham Juratli, MD, MPHNPI 1629136064

Title

President

Phone

(313) 451-8253

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sham Juratli, M.D.

  • Family Medicine Physician
  • Dearborn, MI
  • NPI 1629136064
  Medicare reassignment NPD Authorized official
• Madison Elizabeth Delmarle, MS, PA-C

  • Medical Physician Assistant
  • Dearborn, MI
  • NPI 1629802491
  Medicare reassignment
• Meredith Ann Halloran, PA-C

  • Physician Assistant
  • Dearborn, MI
  • NPI 1013407261
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1286236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478044800000",
    "number": "1457660789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18181 OAKWOOD BLVD",
            "address_2": "SUITE 206",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481245032",
            "telephone_number": "313-451-8253",
            "fax_number": "313-451-8351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18181 OAKWOOD BLVD",
            "address_2": "SUITE 206",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481245032",
            "telephone_number": "313-451-8253",
            "fax_number": "313-451-8351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLIVE TREE MEDICAL CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-05",
        "last_updated": "2016-11-02",
        "status": "A",
        "authorized_official_last_name": "JURATLI",
        "authorized_official_first_name": "SHAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "313-451-8253",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, MPH"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bola Okpue, RN
• Olajide Oluyinka Okunrounmu, RPT
• Okuns Rehab Services Inc.
• Rosslyn Olariu
• Fatima Olayan
• Elizabeth Marie Oliver, RD
• Greg Oliver, LLP
• Diane Olson, LMSW
• Gregory D Olson, M.D.
• Alexis Marie Olszewski

• Family Medicine Physician in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.