Individual
ROMAN IGOREVICH KRIVOCHENITSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1000 E PARIS AVENUE SE, STE 130, GRAND RAPIDS, MI 49546-3680
(616) 949-2001
(616) 949-8620
Mailing address
5504 TEQUESTA DR, WEST BLOOMFIELD, MI 48323-2356
(248) 895-9719
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
4301105291
MI
207W00000X
Ophthalmology Physician
5859-851
WI
207W00000X
Ophthalmology Physician
DR0061743
CO
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
Primary
4301105291
MI
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
DR0061743
CO
Other
Enumeration date
06/12/2014
Last updated
12/11/2024
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