Individual
MAX HARRIS ENGELMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1323 SPRING ST, PETOSKEY, MI 49770-8720
(231) 439-3937
(231) 439-9058
Mailing address
1323 SPRING ST, PETOSKEY, MI 49770-8720
(231) 439-3937
(231) 439-9058
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901002958
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3522537
—
MI
01
—
900B410480
BLUE CROSS
MI
01
—
P50250001
MEDICARE WPS
MI
Enumeration date
08/01/2006
Last updated
05/06/2014
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