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Organization

SHELBY EYECARE ASSOCIATES PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. MARIE DORAU (OFFICE MANAGER)
(586) 739-9550
Entity
Organization

Contact information

Practice address
48187 VAN DYKE AVE, SHELBY TOWNSHIP, MI 48317-3268
(586) 739-9550
(586) 739-0083
Mailing address
48187 VAN DYKE AVE, SHELBY TOWNSHIP, MI 48317-3268
(586) 739-9550
(586) 739-0083

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901003013
MI
152WC0802X
Corneal and Contact Management Optometrist
4901003013
MI
152WP0200X
Pediatric Optometrist
4901003013
MI
152WS0006X
Sports Vision Optometrist
4901003013
MI
152WV0400X
Vision Therapy Optometrist
4901003013
MI
152WX0102X
Occupational Vision Optometrist
4901003013
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
002109A
VSP GROUP NUMBER
MI
01
P90472
BLUE CARE NETWORK
MI
Enumeration date
05/23/2006
Last updated
12/29/2010
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