Organization
NEO OCULOPLASTIC P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TINA MIRCHEV (CREDENTIALING SPECIALIST)
(734) 673-2946
Entity
Organization
Contact information
Practice address
44067 GREENVIEW LN, NORTHVILLE, MI 48168-8454
(734) 673-2946
Mailing address
44067 GREENVIEW LN, NORTHVILLE, MI 48168-8454
(734) 673-2946
Taxonomy
Speciality
Code
Description
License number
State
207WX0200X
Ophthalmic Plastic and Reconstructive Surgery Physician
Primary
—
—
Other
Enumeration date
12/04/2023
Last updated
12/04/2023
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