Organization
PRIMARY VISION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE WILLIAM MCNIVEN OD (PRESIDENT)
(810) 648-4242
Entity
Organization
Contact information
Practice address
33 W SANILAC RD, SANDUSKY, MI 48471-1036
(810) 648-4242
(810) 648-4248
Mailing address
33 W SANILAC RD, PO BOX 112, SANDUSKY, MI 48471-1036
(810) 648-4242
(810) 648-4248
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901002288
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
900G665050
BCBS OF MI
MI
Enumeration date
11/14/2007
Last updated
11/14/2007
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