Individual
BRIAN M HALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1520 N MCEWAN ST # B, CLARE, MI 48617-1196
(989) 386-2020
(989) 386-7308
Mailing address
1520 N MCEWAN ST # B, CLARE, MI 48617-1196
(989) 386-2020
(989) 386-7308
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901004640
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0A80041
BLUECROSS BLUESHIELD OF MICHIGAN
MI
05
—
1154619286
—
MI
01
—
P01126593
RAILROAD MEDICARE
MI
Enumeration date
07/11/2011
Last updated
02/13/2013
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