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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