Individual
DR. MARC AUSTHOF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2640 CROSSING CIR, TRAVERSE CITY, MI 49684-7930
(231) 933-7195
(231) 933-7197
Mailing address
2640 CROSSING CIR, TRAVERSE CITY, MI 49684-7930
(231) 933-7195
(231) 933-7197
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901003842
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
90-0-B8-1061-0
BLUE CROSS BLUE SHIELD
MI
Enumeration date
08/17/2006
Last updated
06/18/2010
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