Organization
STADIUM OPTICIANS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES R. MELDRUM OPTICIAN (PRES.)
(734) 663-0870
Entity
Organization
Contact information
Practice address
2333 W STADIUM BLVD, ANN ARBOR, MI 48103-3844
(734) 663-0870
(734) 761-5242
Mailing address
2333 W STADIUM BLVD, ANN ARBOR, MI 48103-3844
(734) 663-0870
(734) 761-5242
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901003645
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
900H16511
BCBS OF MI VISION
MI
Enumeration date
01/23/2007
Last updated
08/22/2020
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