Individual
MR. TERRENCE NORTON DONOVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
B.C.O.
Contact information
Practice address
33612 SCHOOLCRAFT RD, LIVONIA, MI 48150-1540
(734) 425-3430
(734) 425-8090
Mailing address
33612 SCHOOLCRAFT RD, LIVONIA, MI 48150-1540
(734) 425-3430
(734) 425-8090
Taxonomy
Speciality
Code
Description
License number
State
156FX1700X
Ocularist
Primary
5001000008
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5090486
—
MI
01
—
540Q20959
BLUE CROSS
MI
Enumeration date
07/26/2006
Last updated
11/19/2007
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