Individual
ROBERT E MOLTER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
882 M 72 NW, KALKASKA, MI 49646
(231) 258-9781
(231) 258-0616
Mailing address
PO BOX 12, CHARLEVOIX, MI 49720-0012
(231) 487-0478
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901003025
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0800300001
MEDICARE MATERIALS
MI
01
—
410018558
RAILROAD
MI
01
—
900D065010
BLUE CROSS BLUE SHIELD
MI
05
—
943292016
—
MI
01
—
MI3025
EYEMED
MI
01
—
OPC2085
STATE LICENSE
FL
01
—
RM003025
STATE LICENSE
MI
Enumeration date
08/14/2006
Last updated
03/07/2023
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