Organization
20-20 EYECARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELHAM DANESHVAR OD (DOCTOR OF OPTOMETRY)
(248) 444-6496
Entity
Organization
Contact information
Practice address
12415 E 12 MILE RD, WARREN, MI 48093-3586
(586) 473-4477
(586) 573-0305
Mailing address
28210 HAWBERRY RD, FARMINGTON HILLS, MI 48331-3320
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901004871
MI
152WC0802X
Corneal and Contact Management Optometrist
4901004871
MI
152WL0500X
Low Vision Rehabilitation Optometrist
4901004871
MI
152WP0200X
Pediatric Optometrist
4901004871
MI
152WS0006X
Sports Vision Optometrist
4901004871
MI
152WV0400X
Vision Therapy Optometrist
4901004871
MI
152WX0102X
Occupational Vision Optometrist
4901004871
MI
Other
Enumeration date
09/25/2017
Last updated
09/25/2017
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