Individual
REBECCA P TISCH
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
7949 N CANTON CENTER RD, CANTON, MI 48187-1533
(734) 459-7850
(734) 459-5799
Mailing address
7949 N CANTON CENTER RD, CANTON, MI 48187-1533
(734) 459-7850
(734) 459-5799
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
4301407480
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000004109
CAPE MEDICAID
MI
01
—
028226
MIDWEST HEALTH
MI
01
—
103675
CARE CHOICES
MI
01
—
1208226271
BLUE CROSS AND BLUE SHIEL
MI
01
—
1505581001
CIGNA
MI
01
—
15709
SPECTERA
MI
05
—
2667834
—
MI
01
—
4123804
AETNA
MI
01
—
4301407480
STATE LICENSE NUMBER
MI
01
—
79834
ONE HEALTH PLAN
MI
01
—
B6710
MCARE
MA
01
—
P50982
BLUE CARE NETWORK
MI
Enumeration date
05/23/2005
Last updated
07/08/2007
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