Organization
BI COUNTY OPHTHALMOLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JESSE J CARDELLIO DO (OWNER/ PRESIDENT)
(586) 756-5060
Entity
Organization
Contact information
Practice address
28001 SCHOENHERR RD, SUITE 2, WARREN, MI 48088-4396
(586) 756-5060
(586) 756-9783
Mailing address
28001 SCHOENHERR RD, SUITE 2, WARREN, MI 48088-4396
(586) 756-5060
(586) 756-9783
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
—
332H00000X
Eyewear Supplier
005215
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111536954
—
MI
Enumeration date
01/16/2008
Last updated
01/29/2014
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