Individual
DR. DOUGLAS E GILLIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1180 N MONROE ST, MONROE, MI 48162-3190
(734) 243-5300
(734) 243-9956
Mailing address
1180 N MONROE ST, MONROE, MI 48162-3190
(734) 243-5300
(734) 243-9956
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
3071T456
OH
152W00000X
Optometrist
Primary
4901002418
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0261729
—
OH
01
—
410049893
MEDICARE RAILROAD
OH
01
—
410049894
MEDICARE RAILROAD
MI
05
—
944352709
—
MI
Enumeration date
06/16/2005
Last updated
02/16/2009
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