Individual
DR. DANIEL G BALCUEVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
735 JOHN R RD, TROY, MI 48083-5856
(248) 544-3290
(248) 528-4040
Mailing address
655 W 13 MILE RD, MADISON HEIGHTS, MI 48071-1850
(248) 588-9300
(248) 588-9917
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
18003721
IN
152W00000X
Optometrist
Primary
4901004830
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1659636017
—
MI
05
—
201202570
—
IN
Enumeration date
07/11/2012
Last updated
09/15/2015
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