Organization
CHARLOTTE LIIOI HARTZELL, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLOTTE LIIOI HARTZELL M.D. (PRESIDENT)
(313) 884-2009
Entity
Organization
Contact information
Practice address
2877 CROOKS RD, SUITE B, TROY, MI 48084-4717
(313) 318-8205
Mailing address
515 HEATHER LN, GROSSE POINTE WOODS, MI 48236-1509
(313) 884-2009
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
4301052708
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1806361411
BCBSM OF MICIGAN
MI
Enumeration date
09/06/2007
Last updated
02/06/2009
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