Organization
LEGACY EYE INSTITUTE PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ATHEAR ALRAWI MD (DOCTOR/OWNER)
(248) 229-8436
Entity
Organization
Contact information
Practice address
811 EAST ST, LAPEER, MI 48446-3033
(810) 267-9700
(810) 356-5819
Mailing address
811 EAST ST, LAPEER, MI 48446-3033
(810) 267-9700
(810) 356-5819
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11810958
CAQH
MI
Enumeration date
12/19/2019
Last updated
12/19/2019
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