Individual
DR. RAYMOND KRIST ATANASOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
131 W GENESEE STREET, IRON RIVER, MI 49935
(906) 265-9931
(906) 265-6202
Mailing address
131 W GENESEE STREET, IRON RIVER, MI 49935
(906) 265-9931
(906) 265-6202
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2518
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0776580001
ADIMASTER
MI
01
—
580002464
RAILROAD MEDICARE
MI
01
—
900C664040
BCBS
MI
05
—
945047510
—
MI
Enumeration date
08/03/2006
Last updated
08/19/2008
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