Northwest Ophthalmology,pc
Ophthalmology in Southfield, MI. Organization (NPI-2).
NPI number1023205366
StatusActive
Last updated in NPPESApr 9, 2008
Details
- NPI
- 1023205366
- Entity type
- Organization (NPI-2)
- Legal business name
- Northwest Ophthalmology,pc
- Organization subpart
- No
- Enumeration date
- Oct 1, 2007
- Last updated
- Apr 9, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207W00000X | Ophthalmology | – | – | Yes |
Practice location
26771 W 12 Mile RdSuite 105
Southfield, MI 48034-1539
Phone 248-352-8815 · Fax 248-352-9157
Mailing address
26771 W 12 Mile RdSuite 105
Southfield, MI 48034-1539
Phone 248-352-8815 · Fax 248-352-9157
Authorized official
Gerald J Burke
President
2483528815
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