Organization
NORTHLAND RETINA ASSOC
Active
Organization
NORTHLAND RETINA ASSOC
Active
Other names
Oakland Retina Cons
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FREDERICK JOHN HEYNER MD (PRESIDENT)
(248) 569-0131
Entity
Organization
Contact information
Practice address
22250 PROVIDENCE DR, STE 607, SOUTHFIELD, MI 48075
(248) 569-0131
(248) 569-0132
Mailing address
22250 PROVIDENCE DR, STE 607, SOUTHFIELD, MI 48075
(248) 569-0131
(248) 569-0132
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
4301023890
MI
Other
Enumeration date
09/11/2006
Last updated
08/22/2020
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