Organization
M.D. OPTICAL, LTD
Active
Organization
M.D. OPTICAL, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FRANK NELSON DERR M.D. (PRESIDENT)
(248) 852-3636
Entity
Organization
Contact information
Practice address
375 BARCLAY CIR, ROCHESTER HILLS, MI 48307-4511
(248) 852-3636
(248) 852-3631
Mailing address
375 BARCLAY CIR, ROCHESTER HILLS, MI 48307-4511
(248) 852-3636
(248) 852-3631
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
MI
332H00000X
Eyewear Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
540F328670
BLUE CROSS BLUE SHIELD
MI
Enumeration date
08/08/2006
Last updated
07/21/2022
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