Dr. Debra E Bourdeau, O.D.
Optometrist in Commerce Township, MI. Individual provider (NPI-1).
NPI number1790764173
StatusActive
Last updated in NPPESJan 14, 2016
Details
- NPI
- 1790764173
- Entity type
- Individual (NPI-1)
- Name
- Dr. Debra E Bourdeau
- Credential
- O.D.
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jan 12, 2006
- Last updated
- Jan 14, 2016
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - OPTOMETRY
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility No · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | 4901004051 | MI | Yes |
Practice location
3050 Union Lake RdSte 3b
Commerce Township, MI 48382-4509
Phone 248-360-4300 · Fax 248-360-4503
Mailing address
3050 Union Lake Rd Ste 3bCommerce Township, MI 48382-4563
Phone 248-360-4300
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 14 Optometrist providers in Commerce Township · All 657 providers in Commerce Township
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