Organization
FRASER OPTICAL CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK ANDREW STEFANI DO (DOCTOR OWNER)
(586) 293-8888
Entity
Organization
Contact information
Practice address
32925 GROESBECK HIGHWAY, FRASER, MI 48026
(586) 293-8888
(586) 296-0726
Mailing address
32925 GROESBECK HIGHWAY, FRASER, MI 48026
(586) 293-8888
(586) 296-0726
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
332H00000X
Eyewear Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110955
EYEMED
—
05
—
3404800
—
MI
01
—
900E06513
BCBS
—
Enumeration date
11/27/2006
Last updated
02/05/2008
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