Individual provider · NPI-1

Robert Allan Beaulieu, MD

Ophthalmology · Royal Oak, MI

NPI number1750700746
StatusActive
Last updated in NPPESJul 19, 2022

Details

NPI
1750700746
Entity type
Individual (NPI-1)
Name
Robert Allan Beaulieu
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
Apr 7, 2014
Certification date
Jul 19, 2022
Last updated
Jul 19, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207W00000X Ophthalmology4301114144MIYes
207W00000X Ophthalmology4301114144PA
207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery4301114144MI

Practice location

3535 W 13 Mile Rd Ste 555
Royal Oak, MI 48073-6770

Phone 248-551-2020

Mailing address

26901 Beaumont Blvd Ste 3d
Southfield, MI 48033-3849

Other practice locations

29201 Telegraph Rd Ste 324
Southfield, MI 48034-7646

Phone 248-357-5100

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